I understand that it is very scary to put a small child on an anti-psychiotic drug. If weight gain is the only side-effect, then it is a no-brainer. If the diagnosis fits and the medicine works, then these children should be on the correct medicine.
Antipsychotic drugs for kids raise hope, worry
(06-21) 19:38 PDT -- Increasingly powerful antipsychotic drugs available on the market, and growing evidence that starting these medications early can help children with conditions like bipolar disorder, is putting doctors under more pressure than ever to diagnose and treat young people with mental illnesses.
As a result, some doctors say, mental illness, especially bipolar disorder, has been overdiagnosed much the same way attention deficit hyperactivity disorder was in the 1980s.
"ADHD was the diagnosis du jour in the '80s. Now it's become bipolar disorder," said Dr. Andrew Giammona, who heads the psychiatry department at Children's Hospital Oakland. "We're in a quick-fix society, and parents want to believe that if we had this treatment, we can get it fixed and move on."
Before the 1990s, bipolar disorder was a rare diagnosis in children under age 19. By 1994, U.S. doctors were reporting about 25 cases per 100,000 young people, and by 2002 that number had jumped to 1,000 cases per 100,000, according to data from the National Center for Health Statistics.
Medication was prescribed for about two-thirds of those patients, according to the National Institute of Mental Health. Antipsychotic medications are among the most popular made by pharmaceutical companies. Earlier this month, a U.S. Food and Drug Administration panel recommended approval of three antipsychotic drugs for use in treating schizophrenia and bipolar disorder in children and teens. The FDA will make a final decision on Geodon, Seroquel and Zyprexa in the coming weeks.
While better drugs and increased diagnoses have been a blessing for many families, at FDA hearings in Washington, doctors and parents voiced concerns that the medication can cause long-term health problems - specifically, extreme weight gain that can lead to metabolic disorders like diabetes.
Not a trivial decision
"It would be controversial enough if it was just a diagnosis, but the diagnosis comes with these very potent medications," said Glen Elliot, chief psychiatrist and medical director of the Children's Health Council in Palo Alto. "My main message is parents need to be apprised that this is a cost-benefit analysis. You don't trivially put somebody on a medication."
As with ADHD, many thousands of children and teens really do have a mental illness that can be treated effectively with medication and therapy. Oakland parent Barbara Carlson said her son was 7 when he started having fits of violent rages, smashing windows and throwing chairs. After several days of testing, he was diagnosed with bipolar disorder - but she was reluctant to put him on medication. "He was just so young," Carlson said. "I thought, 'He has his whole life ahead of him, what if this is the wrong diagnosis?' It was very scary to put him on medications."
Seven years later, she said the drugs have improved his life dramatically. He's had weight problems, but he's excelling in school and is active in sports and making friends.
Many mental health experts said they've felt pressure from families with troubled children to make a diagnosis and start treatment - a reaction that's understandable if the child is clearly having problems. But if doctors don't have the proper training to accurately diagnose a mental illness, children may not get the right treatment, said Dr. Robin Dea, director of mental health services for Northern California Kaiser Permanente.
Depression and mania
"I tell doctors, 'You have to be honest with yourself about your own level of experience with this condition,' " Dey said. "We have to be honest with ourselves about whether the medications are working, and if they're not working you need to keep questioning the diagnosis."
Bipolar disorder is thought to affect about 1 percent of children, although studies vary and some experts believe it affects as many as 5 percent of children.
The disorder in adults is marked by extended cycles of depression and mania, although people can have long periods of time where they have no symptoms at all. During manic periods, adults may get grandiose ideas, feel euphoric and be impulsive and make poor decisions.
Children with bipolar disorder tend to cycle through moods faster than adults, and they are more likely to be extremely irritable than euphoric, said Dr. Kiki Chang, director of the Pediatric Bipolar Disorders Program at Stanford University School of Medicine. Experts note that these children are not just kids with behavior problems.
"An irritable kid is most likely not bipolar, he's probably just upset about something," Chang said. "Bipolar kids may be extremely explosive, extremely angry. But they have to have these other symptoms: they're not sleeping as much, their mind is going faster and they're making poor decisions."
Hard to tell the difference
It's not always easy for doctors to tell the difference between a kid with bipolar disorder and one who's dealing with teenage angst or has some other problem, like post-traumatic stress. Giammona at Oakland Children's Hospital said he once diagnosed a child with bipolar disorder only to discover later that the patient had a food allergy that was making him extremely irritable.
"There's a lot of overlap with other potential diagnoses," he said. "There can be lots of reasons for symptoms that look like bipolar disorder. Just because they have the symptoms of the disorder doesn't mean they have it."
Dale Milfay, vice president of the National Alliance on Mental Illness in San Francisco, said it's crucial that children with mental illness get a correct diagnosis as soon as possible and start treatment right away. There may be medical advantages to early treatment, she said, but children also benefit from staying in school and developing crucial relationships with friends and family.
"The earlier people are diagnosed, the better their chances," Milfay said. "But you wouldn't want these drugs to be overused. There needs to be some real criteria that this is not something a primary care doctor can just diagnose."
Monday, June 22, 2009
Wednesday, June 3, 2009
EEEEVVVVVEEEEERRRRYYYY DAY!
This sounds like a broken record, I see this almost every day in the world of Special Education. The parents take their children off the medicine and don't take them to their counselors. Here is a very true list of what we have seen in the last two weeks of school
1. "M"'s mom takes him off his meds. because we only have two weeks left and surely we don't need him to take his drugs, he is a 4th grader who then goes "poo" in his pants and spreads it around the school in little "poo" bombs.
2. "Z" is tired of working and when the teachers give him an assignment he says"I am not doing any more Effing work" His mothers solution was to have him write 100 times at home that he will not use the "F bomb" again. The next day he got into a fight and used the "F bomb" with the assistant principal which earned "Z" the right to have On Campus Suspension and miss his end of year party
3. "J" does not take his medicine and his mother says it won't hurt him to miss a few days, so he flies around the room, uses the F-bomb with a teacher, won't stay in his chair at all and can't focus, so he had a wasted learning day and the teachers had to send him to the principal where he was told if he did not take his meds. the next day he would join "Z" in OCS, he made the right choice the next day and took his meds.
4. "C" admits that his mother spreads his meds. on a half PBJ sandwich because he can't swallow the pill but he has actually been feeding it to the dog which explains why the teachers were puzzled when the mother said his meds had been increased in the last month and were perplexed as to why he can't pass the second round of State Mandated Tests and now has to attend summer school.
So you decide, is it important to take your prescribed meds.? absolutely "YES".
Youth with history of mental illness gets probation for break-in
BLOOMINGTON -- A 12-year-old Bloomington boy who broke into two homes in Normal last year was placed on 60 months probation Wednesday and ordered to cooperate with attempts to help him avoid future problems with the law.
McLean County Assistant State’s Attorney Aaron Hornsby described Sept. 18 as “a truly frightening day and what were truly frightening crimes.”
The youth and a second boy got off the school bus where they were scheduled to attend special education classes and instead broke into two homes, said Hornsby.
An 83-year-old resident of one of the homes saw the two as they left his property and called police. When the 12-year-old was stopped, he was waving two knives, said the prosecutor.
The youth’s background includes a history of mental illness and two suicide attempts, according to Hornsby.
The state asked that the minor be placed on probation until he is 21 years old.
In her remarks prior to her decision to place the youth on probation until he is 17, Judge Elizabeth Robb said she was troubled by reports indicating the child was taken off medication by his mother and missed counseling appointments.
Calling the mother’s decisions irresponsible, Robb told the parent, “he’s not going to function without medication.”
The mother was ordered to work with child welfare, school and court services staff assigned to the child’s case.
Defense lawyer Art Feldman agreed that the child’s mental health issues must be addressed.
“It’s clear to me that the minor has mental health issues. It’s a matter of how to deal with them,” he said.
An Aug. 3 hearing is scheduled to review the boy’s progress.
t
1. "M"'s mom takes him off his meds. because we only have two weeks left and surely we don't need him to take his drugs, he is a 4th grader who then goes "poo" in his pants and spreads it around the school in little "poo" bombs.
2. "Z" is tired of working and when the teachers give him an assignment he says"I am not doing any more Effing work" His mothers solution was to have him write 100 times at home that he will not use the "F bomb" again. The next day he got into a fight and used the "F bomb" with the assistant principal which earned "Z" the right to have On Campus Suspension and miss his end of year party
3. "J" does not take his medicine and his mother says it won't hurt him to miss a few days, so he flies around the room, uses the F-bomb with a teacher, won't stay in his chair at all and can't focus, so he had a wasted learning day and the teachers had to send him to the principal where he was told if he did not take his meds. the next day he would join "Z" in OCS, he made the right choice the next day and took his meds.
4. "C" admits that his mother spreads his meds. on a half PBJ sandwich because he can't swallow the pill but he has actually been feeding it to the dog which explains why the teachers were puzzled when the mother said his meds had been increased in the last month and were perplexed as to why he can't pass the second round of State Mandated Tests and now has to attend summer school.
So you decide, is it important to take your prescribed meds.? absolutely "YES".
Youth with history of mental illness gets probation for break-in
BLOOMINGTON -- A 12-year-old Bloomington boy who broke into two homes in Normal last year was placed on 60 months probation Wednesday and ordered to cooperate with attempts to help him avoid future problems with the law.
McLean County Assistant State’s Attorney Aaron Hornsby described Sept. 18 as “a truly frightening day and what were truly frightening crimes.”
The youth and a second boy got off the school bus where they were scheduled to attend special education classes and instead broke into two homes, said Hornsby.
An 83-year-old resident of one of the homes saw the two as they left his property and called police. When the 12-year-old was stopped, he was waving two knives, said the prosecutor.
The youth’s background includes a history of mental illness and two suicide attempts, according to Hornsby.
The state asked that the minor be placed on probation until he is 21 years old.
In her remarks prior to her decision to place the youth on probation until he is 17, Judge Elizabeth Robb said she was troubled by reports indicating the child was taken off medication by his mother and missed counseling appointments.
Calling the mother’s decisions irresponsible, Robb told the parent, “he’s not going to function without medication.”
The mother was ordered to work with child welfare, school and court services staff assigned to the child’s case.
Defense lawyer Art Feldman agreed that the child’s mental health issues must be addressed.
“It’s clear to me that the minor has mental health issues. It’s a matter of how to deal with them,” he said.
An Aug. 3 hearing is scheduled to review the boy’s progress.
t
Monday, May 25, 2009
Infancy?
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.
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."
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.
KTDUP
Uncle says mental illness at root of Manchester pacemaker attack
By Matthew Wilde
Waterloo Courier
Photo
(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."
Photo
(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."
KTDUP
Uncle says mental illness at root of Manchester pacemaker attack
By Matthew Wilde
Waterloo Courier
Photo
(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."
Photo
(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
* CHART
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.
Click to view previous image
1 of 2
Click to view next image
"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.
Don't Miss
* Less sun, more depression for people with SAD
* Expert Q & A: How can I safely wean off an antidepressant?
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
* MayoClinic.com: Depression
* MayoClinic.com: Mental health
* MayoClinic.com: 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."
advertisement
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.
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
* CHART
By Shahreen Abedin
CNN Senior Medical Producer
Decrease font Decrease font
Enlarge font Enlarge font
(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.
Click to view previous image
1 of 2
Click to view next image
"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.
Don't Miss
* Less sun, more depression for people with SAD
* Expert Q & A: How can I safely wean off an antidepressant?
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
* MayoClinic.com: Depression
* MayoClinic.com: Mental health
* MayoClinic.com: 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."
advertisement
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
Wishing
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.
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.
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