mental illness

RECENT POSTS

The OCD In Us All: Study Finds Almost Everyone Has Intrusive Thoughts

Some people with OCD wash their hands compulsively. (Wikimedia Commons)

Some people with OCD wash their hands compulsively. (Wikimedia Commons)

Confession: Every time I flush the toilet, I have to be out of the bathroom before the last of the water goes down the pipe. If I’m not — well, I don’t know. Something bad will happen. And when I’m choosing a spoon for breakfast — only breakfast, not later meals — sometimes I’m seized by the feeling that I’ve chosen the wrong spoon. If I use it, I doom the day. I put it back into the silverware tray and choose another.

I knew that I was far from alone — that Obsessive-Compulsive Disorder-type thoughts and behaviors are extremely widespread. But not this widespread. A study just out in the Journal of Obsessive-Compulsive and Related Disorders suggests to me that if you don’t have any of these thoughts and behaviors, you’re the weird one.

The study looked at 777 university students in 13 countries, including Canada, Israel, Iran and the United States. From the press release:

International study finds that 94 percent of people experience unwanted, intrusive thoughts

Montreal, April 8, 2014 — People who check whether their hands are clean or imagine their house might be on fire are not alone. New research from Concordia University and 15 other universities worldwide shows that 94 per cent of people experience unwanted, intrusive thoughts, images and/or impulses. Continue reading

Study: Primary Care May Be Path To More Effective Suicide Prevention

The unanswerable question, “What If?” often dominates the talk when it comes to illness. What if the tumor had been caught earlier; what if the child’s ache taken more seriously? When it comes to suicide, the agonizing “What Ifs?” can run rampant.

Recently, following three suicide deaths by high school students in Newton, Mass. there has been much talk about what, if anything, might have been done to prevent these acts.

A new national study offers no easy answers — indeed, many people who die by suicide do so without any prior mental health diagnosis, researchers report. But this new research does suggest there may be opportunities — through primary care doctors, and other specialists, for instance — to more accurately identify people at risk for suicide, and perhaps intervene before it’s too late.

The new federally-funded study — based on a longitudinal review of more than 5,800 people who died by suicide from 2000 to 2010 — found that nearly all of these individuals (83 percent) saw a doctor or received some kind of health care in the year prior to their death, but half of those individuals did not have a mental health diagnosis. Moreover, researchers report: “Only 24% had a mental health diagnosis in the 4-week period prior to death.”

Also, strikingly, one in every five people who died by suicide “made a health care visit in the week before their death,” says the paper’s lead author Brian K. Ahmedani, Ph.D., assistant scientist in the Center for Health Policy and Health Services Research at Henry Ford Health System in Detroit, who speaks about the work in an accompanying video.

The study, published online in the Journal of General Internal Medicine, concludes that: “Greater efforts should be made to assess mental health and suicide risk. Most visits occur in primary care or medical specialty settings, and suicide prevention in these clinics would likely reach the largest number of individuals.”

Of course, that’s easier said than done. Anyone familiar with a typical primary care visit knows it can be, well, a bit rushed — not quite the perfect venue for dwelling on complicated emotional issues that may be difficult to articulate. Unless specific psychiatric symptoms are raised, they are often not part of routine care, says Massachusetts General Hospital psychiatrist Steven C. Schlozman, Continue reading

Parent View: Adam Lanza’s Mother Would Have No Better Help Today

Flowers, candles and stuffed animals make up a makeshift memorial in Newtown, Conn., days after the 2012 shooting. (Reuters/Landov)

Flowers, candles and stuffed animals make up a makeshift memorial in Newtown, Conn., days after the 2012 shooting. (Reuters/Landov)

Soon after the Newtown shooting, a viral blog post titled “I am Adam Lanza’s mother” captured one mother’s anguish over having a mentally ill and violent child. Lisa Lambert, the executive director of the Parent/Professional Advocacy League — subtitled “The Massachusetts Family Voice For Children’s Mental Health” — responded by eloquently describing the public silence that usually prevails among such parents in the face of widespread stigma and hostility, and the damage it does. Her post was titled Parents of Mentally Ill Children: ‘We Don’t Tell You And Here’s Why.

Today, a year after the shooting, NPR reports that promises to fix the mental health system after Newtown remain unfilfilled. And USA Today reporter Liz Szabo tweeted from Capitol Hill this week: “Mental health reform struggles to get attention. Rep. Tim Murphy announced major bill. Almost no one showed up.”

Here, Lisa Lambert looks at the effects of the Newtown shooting — and the lack thereof — on children with mental illness and their families, one year later.

By Lisa Lambert
Guest contributor

Dec. 14 will be the first anniversary of the Newtown school shootings that took the lives of 20 young children and six school staff. Adam Lanza also shot his mother, Nancy, and later shot himself. In the aftermath of those 28 deaths, intense conversations took place both publicly and privately about mental health, guns and prevention. We asked ourselves what went wrong and what needed to change so this wouldn’t happen again.

Twelve months later, not much has changed.

Last December, many families whose children have mental health needs were optimistic that there would be a renewed focus and the will to take a hard look at the children’s mental health “system.”

Those of us who use it, work in it or navigate it realized that while there might not be a wholesale fix, even some patching up could make an impact.  Many of us told our stories and shared our worries in an effort to keep this important discussion on the front burner. We were hopeful. Finally mental health, especially children’s mental health, was getting the attention it needed.

The early reports about Adam Lanza and his mother, Nancy, highlighted his bizarre behavior and isolation and their slow drift into accepting these things as the new normal. Those reports sounded a lot like the personal stories many families tell when they call my organization for help, as well as the story of my own son.

When he was younger, I watched him become wildly enraged at trivial slights and fearful of ordinary things. Once, in a movie theatre, he ran screaming to the lobby because an adult character became out of control, which mirrored the way he was feeling. We all hoped these stories would point out his dire needs — and our own.

Instead, the conversation about mental health and children has focused on training teachers, creating a registry of people who have been hospitalized and, of course, guns. There are new funding and education programs for teachers and other school employees to recognize the signs of “mental illness.”

While it’s always a welcome idea to invest more money into children’s mental health, most parents will tell you that they notice something worrisome going on with their child long before the teacher does. But there’s no funding to teach parents the same skills and facts, and no recognition that we can be valuable “first responders,” even though most parents are pretty expert about their children. For parents, not much has changed. Continue reading

The Checkup: Meltdown U. And Mental Health Tips For Parents Of College Kids

For all those freshman just settling into dorm life this fall, college can be exhilarating, mind-blowing, the best years of their lives. But many parents don’t realize that their children are also facing a potential double whammy. Not only must new students navigate an entirely unfamiliar social, emotional and intellectual landscape, but they’re also entering a time in their lives — the ages between 18 and 21 — when many mental illnesses, from anxiety to depression to eating disorders, peak.

This week, The Checkup, our podcast on Slate, explores the mental health of college students. Here’s one sobering statistic: up to 50% of college-age kids have had or will have some kind of psychiatric disorder. That’s why we’re calling this episode “Meltdown U.” (To listen to The Checkup now, click on the arrow above; to download and listen later, press Download; and to get it through iTunes click here.)

The Checkup

Consider some more scary numbers:

–80% of college students who need mental health services won’t seek them

–50% of all college students say they have felt so depressed that they found it difficult to function during the last school year

–Suicide is the second leading cause of death among college-age youth – over 1000 deaths per year.

–The rate of student psychiatric hospitalizations has tripled in the past 20 years.

We asked Dr. Eugene Beresin, M.D., a child psychiatrist at Massachusetts General Hospital and professor of psychiatry at Harvard Medical School, to offer some guidance on what parents should know about helping their college-age kids cope with the high stress of undergraduate life. Here’s his advice: Continue reading

Caffeine Withdrawal As A Mental Illness? Really?

I’ve had the headaches and grumpiness and desperate yearnings that accompany giving up my beloved daily Americano. But come on, caffeine withdrawal as a mental illness? Isn’t that just a wee bit farfetched?

Brietta Mengel/Health Care Savvy

(Source: Topcounselingschools.org — click to view full version)

Apparently not. Caffeine use disorder is right there in Section III of the DSM-5, the latest edition of the bible of psychiatric disorders formally known as the Diagnostic and Statistical Manual of Mental Disorders.

“Caffeine is a drug, a mild stimulant, used by almost everybody on a daily basis,” explains Charles O’Brien, MD, PhD, chair of the substance-related disorders work group of the American Psychiatric Association, which publishes the DSM. “But it does have a letdown afterwards.”

Indeed, and for some more than others. (For the full rationale behind caffeine withdrawal’s elevated status as a disorder worthy of further discussion, watch the video here.) Continue reading

Study: Seasons May Affect Mental Health More Than Previously Thought

It may truly feel like summer today, which could bode well for people with a range of mental illness (and not just those of us with seasonal affective disorder desperately awaiting warmth and sunshine).

A new analysis of mental health inquiries in the U.S. and Australia found that Google searches for specific mental illnesses — including eating disorders, schizophrenia and bi-polar disorder, were all down in summertime compared to winter. This led researchers to surmise that mental illness of all varieties may have stronger links to the seasons than previously thought. The new work (with funding from Google.org) is published in the May issue of the American Journal of Preventive Medicine.

sunbatherFrom the news release:

Using Google’s public database of queries, the study team identified and monitored mental health queries in the United States and Australia for 2006 through 2010. All queries relating to mental health were captured and then grouped by type of mental illness, including ADHD (attention deficit-hyperactivity disorder), anxiety, bipolar, depression, eating disorders (including anorexia or bulimia), OCD (obsessive compulsive disorder), schizophrenia, and suicide. Using advanced mathematical methods to identify trends, the authors found all mental health queries in both countries were consistently higher in winter than summer.

The research showed eating disorder searches were down 37 percent in summers versus winters in the U.S., and 42 percent in summers in Australia. Schizophrenia searches decreased 37 percent during U.S. summers and by 36 percent in Australia.

Bipolar searches were down 16 percent during U.S. summers and 17 percent during Australian summers; ADHD searches decreased by 28 percent in the U.S. and 31 percent in Australia during summertime. OCD searches were down 18 percent and 15 percent, and bipolar searches decreased by 18 percent and 16 percent, in the U.S. and Australia respectively.

Searches for suicide declined 24 and 29 percent during U.S. and Australian summers and anxiety searches had the smallest seasonal change – down 7 percent during U.S. summers and 15 percent during Australian summers.

While some conditions, such as seasonal affective disorder, are known to be associated with seasonal weather patterns, the connections between seasons and a number of major disorders were surprising. “We didn’t expect to find similar winter peaks and summer troughs for queries involving every specific mental illness or problem we studied, however, the results consistently showed seasonal effects across all conditions – even after adjusting for media trends,” said James Niels Rosenquist, MD, PhD, a psychiatrist at Massachusetts General Hospital. Continue reading

Why Has Psychiatric Drug Development Stalled Lately?

colorpills
Just because drug companies get a lot of flak for pushing psychiatric medications, that doesn’t mean anyone wants them to stop developing better ones.

But that is what’s happening: investment in new psychiatric treatments is on the decline, reports Dr. Steven Hyman, former head of the National Institute of Mental Health and now director of the Stanley Center for Psychiatric Research at the Broad Institute. And that decline has hit even though psychiatric drugs have been highly profitable and one in five American adults now takes at least one, he says.

Hyman writes in the latest issue of Cerebrum, the Dana Foundation magazine:

During the past three years the global pharmaceutical industry has significantly decreased its investment in new treatments for depression, bipolar disorder, schizophrenia, and other psychiatric disorders. Some large companies, such as GlaxoSmithKline, have closed their psychiatric laboratories entirely. Others, such as Pfizer, have markedly decreased the size of their research programs. Yet others, such as AstraZeneca, have brought their internal research to a close and are experimenting with external collaborations on a smaller scale.

What’s going on? Read the full article here — a well-written history of attempted progress despite the lack of fundamental understanding of how mental illnesses actually work. And — in keeping with this week’s widespread talk of the new federal brain mapping initiative — Hyman remains optimistic that new scientific advances will bear fruit. He writes:

Our best hope is that the genetics will unfold over the next several years, due to the efforts of large international consortia that have formed to recruit and to study patients. Continue reading

Trapped Lives: Chilling Photos Of Mentally Ill Prisoners

(x1klima/flickr)

(x1klima/flickr)

There’s got to be a better solution.

That’s my takeaway after viewing “Trapped,” a chilling series of photographs by Jenn Ackerman (posted on Slate) that documents the daily injustices of some extremely troubled mentally ill prisoners at the Kentucky State Reformatory.

The pictures underscore the institution’s crass attempts to keep the inmates safe and also protect the corrections officers who manage them. Some examples:

–One inmate is cuffed to his cell and made to wear a “spit mask” used “to prevent him from spitting at the doctors and correctional officers.”

–Another prisoner “stares out of the cell he remains in for 23 hours a day.”

– A correctional officer wearing rubber gloves “comforts an inmate during one of his psychotic episodes” by sticking her fingers through a little slot into his cell. Continue reading

Must-Read: ‘I’m One Of The 26 Percent With Mental Illness’

The Associated Press recently issued new guidelines for reporters on how to write about mental illness — check them out here. They include such reasonable advice as:

Do not describe an individual as mentally ill unless it is clearly pertinent to a story and the diagnosis is properly sourced.

and:

Do not assume that mental illness is a factor in a violent crime, and verify statements to that effect. A past history of mental illness is not necessarily a reliable indicator. Studies have shown that the vast majority of people with mental illness are not violent, and experts say most people who are violent do not suffer from mental illness.

All well and good. But as Dr. Paul Summergrad, chair of psychiatry at Tufts Medical Center, argued at a panel I moderated last week, the guidelines do represent progress but don’t go far enough. One of his points: The vague term “mental illness” is overused. When Apple chief Steve Jobs was ailing, you would not see a headline saying he had “a physical illness” — talk was of cancer or even the type of cancer. Similarly, the more specific a reporter can be about a psychiatric diagnosis, the better.

The guidelines arguably don’t go far enough in many other ways — among them, I was long ago educated by advocates to use “people first” language — “people who have bipolar disorder” — instead of terms like “the mentally ill.” But rather than carp away at the guidelines (though readers, I encourage you to add improvements in the comments below) I’d rather share a positive example of journalism about mental health, a first-person piece just out in the Concord Monitor so brave and so beautifully done that it made me want to stand up and cheer.

It begins:

After the Monitor’s mental health series, “In Crisis,” was published last week, I got one reaction more than any other: Readers were surprised, some unconvinced, that 26 percent of New Hampshire’s residents have a mental health disorder.

The statistic appeared in the second story of the series and came from a 2010 study by the Concord-based New Hampshire Center for Public Policy Studies. The percentage includes a range of diagnoses, from major depression to anxiety problems to bipolar disorder.

“Didn’t 26 percent seem high?” a caller asked me last week.

Not to me. But I’m one of the 26 percent. Continue reading

How A Mother And Son Learned To Live With Psychosis

By Dr. Annie Brewster
Guest Contributor

Chris is a 38-year-old Ph.D. student who spent 10 years struggling with and fighting against his psychotic illness. His condition has been hard to diagnose — it’s been characterized as Bipolar and Schizoaffective Disorder at various times. Regardless of the specific diagnosis, the bottom line is the same: Chris has a lifelong mental health condition. He hears voices, and has suffered from paranoia, depression and mania along the way.

Chris, a 38-year-old grad student, and his mother Eileen (Photo: Courtesy)

Chris, diagnosed with Bipolar Disorder and Schizoaffective Disorder, is now a grad student at the University of New Hampshire. Here he is with his mother Eileen, who fought mightily to get him adequate mental health treatment. (Photo: Courtesy)

His symptoms started when he was a 25-year-old grad student in New York City. Before that, according to his mother, Eileen, he was extremely high functioning — an excellent student, an athlete and a friend to many. She would never have suspected that her son would become ill. But when he grew paranoid and started acting erratically, Eileen began to worry. Ultimately, when she realized how sick her son had become, she knew she had to act. She quickly learned how difficult it is to get help for someone who is mentally ill but over the age of 18. Eventually, after multiple frustrating and unsuccessful attempts to get Chris into treatment, she was told “you need to find three strong men who love him, and you need to go get him, and you need to take him to a hospital,” and this is what she did. Eileen’s story highlights the challenges of navigating the mental health system and of accepting and ultimately embracing her son’s medical condition.

Listen to Chris tell his story here:

Eileen offers her perspective here:

These days, Chris says he is in a different and better place. He has accepted his illness and has learned to manage it with medications, therapy and his support systems. Like any chronic condition, it requires constant monitoring, but he feels equipped to handle the ups and downs and he has become quite skilled at recognizing his symptoms and titrating his medications in response. He is now a Ph.D. student at the University of New Hampshire’s Natural Resources and Earth Systems Sciences program, where he is integrating environmental economics with his background in environmental sciences and engineering. He is engaged to be married and will soon gain a step-daughter. Though his illness complicates his life, he has learned to live with it while maximizing his happiness and productivity. Continue reading