Treating depression and other forms of mental health care
General help and information
Approaches to treatment
The system: issues affecting the treatment of mental illness
ADHD, ADD, and other problems with attention
Anxiety and phobias
Bipolar disorder (manic depressive illness)
Borderline personality disorder
Children's mental health
Cutting and self-harm
Depression,
including Seasonal affective disorder (SAD)
Dual diagnosis (co-occurring disorders)
Eating disorders
Narcissistic personality disorder
Obsessive-compulsive disorder (OCD),
including hoarding behavior
Post-traumatic stress disorder (PTSD)
Schizophrenia
Psychopathy and Personality Disorders
Organizations and other resources geared to mental health
SEE ALSO
Alzheimer's and other forms of dementia and memory loss
Autism spectrum disorders
Bereavement, grief, and recovery
Coping with chronic, rare, and invisible diseases and disorders
Medical mysteries and patient stories
Substance abuse
General help and information about treating mental illness
and taking mental health breaks
• Psych Central
• Mental Health and Substance Abuse (USA.gov) Find mental health resources, help for substance abuse, help for both for veterans.
• Suicide Information, Resources & Support (Healthy Place)
Suicide Help Online
http://www.hopeline.com
http://www.spanusa.org
Suicide Hotlines
1-888-649-1366
1-800-SUICIDE
1-800-784-2433
• Get Mental Illness, Suicide Prevention Help (Natasha Tracy, Bipolar Burble)
• Mental Health Hotline Numbers and Referral Resources (Healthy Place)
• How to know when you need a mental health break and ways to make the most of it (Allyson Chiu, Washington Post, 6-4-21) "Tennis phenom Naomi Osaka’s decision to withdraw from the French Open, citing concerns about her mental health, has been heralded as a “wake-up call” by many in the world of elite athletic competition. But mental health experts hope that discussion of Osaka’s actions transcends the professional sports industry and encourages more Americans to take time off when they need it — and more workplaces to make that possible...In the statement announcing her withdrawal, Osaka, 23, revealed that she has “suffered long bouts of depression” in recent years and highlighted some of the unique pressures of being a high-profile athlete — including being expected to field myriad questions from the media."
See also Naomi Osaka ignites a fight over the future of postgame news conferences (Ben Strauss, Washington Post, 6-3-21) Naomi Osaka, the 23-year-old four-time Grand Slam winner, "announced last week that she would not participate in post-match news conferences during this year’s tournament, citing concerns about her mental health. The French Open responded by fining her $15,000 after she won her first-round match; all four Grand Slams issued a menacing statement that promised to escalate the penalties, including potentially a suspension; and Osaka withdrew, this time detailing bouts of depression and the anxiety she felt facing a room of reporters.
"Her decision left sports and the journalists who cover them grappling with questions about what athletes owe the press and, in turn, what leagues and tournaments owe the players. Those questions are not new but are made trickier to navigate as the power dynamics between athletes and the media shift rapidly and athletes, in increasing numbers, are speaking out about their struggles with their mental health — and their personhood, in general."
See also In Naomi Osaka’s withdrawal, some see a ‘wake-up call’ for sports that neglect mental health (Liz Clark, WaPo, 6-1-21) Her decision has drawn praise from athletes across the sports world.
• The Me You Can't See (AppleTV, May 2021) A new docuseries, co-created by Oprah Winfrey and Prince Harry, that explores mental health and emotional well-being with stories from people around the world. With storytelling at its core, this timely series gives a voice to stories that aim to seek truth, understanding and compassion. It’s about people, our experiences, and why we feel the way that we do.
• Need help? Aunt Bertha helps people in need find social services in their area (Karen Frances Eng, TED Blog, 8-29-14) Aunt Bertha helps people in need find social services in their area. ... Erine Gray is the founder of Aunt Bertha, a free-to-use online platform that makes it easy for anyone in the US to find and apply for social services — anything from Medicare to food stamps to housing — just by typing in a ZIP code at the Aunt Bertha website. Search for free or reduced cost services like medical care, food, job training, and more.
• A Senior’s Guide to Navigating Medicare for Mental Health Treatment (Teresa Greenhill on Last Comforts, 5-18-19) Greenhill is co-creator of Mental Health for Seniors
• National Alliance on Mental Illness (NAMI)
• Mental Health Resources List (Social Work License Map)
• Myth: People Living with Mental Illness Never Really Recover (Report from Canadian Foundation for Healthcare Improvement) "At its worst, living with a mental illness can be devastating, particularly if healthcare delivery systems reinforce the myth that there is no hope for improvement. But a growing body of evidence is showing that recovery of a meaningful life despite the limitations imposed by illness is possible and likely. People with lived experience have known for some time that, with hope, empowerment and support from others, recovery is possible. Promoting a mental health system that views both personal and clinical recovery as the objective can reduce healthcare costs, enhance quality of life, promote social inclusion, and help those living with mental illness lead full and productive lives."
• Ten Things You Can Do for Your Mental Health (Student Life, University Health Service, University of Michigan)
• Mental Health Conference Transcripts (Healthy Place)
• Free or Low-Cost Prescription Medication Assistance (Healthy Place)
• The Highly Sensitive Person by Elaine N. Aron. (“To say this book changed my life would be an understatement. I am forever grateful to Elaine Aron.”—Alanis Morissette, singer) Watch Elena Herdieckerhoff's informative and amusing TED Talk: "The gentle power of highly sensitive people". Herdieckerhoff is a mentor for highly sensitive and empathic entrepreneurs. She explains why we need to change the prevalent cultural narrative around highly sensitive people.
• Fifty psychological and psychiatric terms to avoid: a list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrases (Scott O. Lilienfeld and others, Frontiers in Psychology, 8-3-15). Fascinating, persuasive, and useful.
• I Am A Child Of God Who Suffers From A Mental Illness (Brooke Y. Bowman, Odyssey, 5-3-16) "If you’re brave enough to open up to a healthcare professional and be diagnosed with depression, anxiety, schizophrenia, bipolar mood disorder, personality disorders, PTSD, eating disorders or any other mental health illnesses, you will feel uncomfortable. If any of your friends and family go through this experience, you will feel uncomfortable. Don’t let this stop you from asking questions. Learn about your disorder, ask your friends and family questions if they come out of the “mental health closet.” We cannot end the stigma on mental health until we take away the shame attached. Start the conversation, overshare, and dare to challenge your friends and family to feel uncomfortable."
5 Tips for Journalists Covering Mental and Behavioral Health (Katia Savchuk, NiemanStoryboard, 1-18-18) Reporters too often fall back on dated stereotypes, distort the nature of illnesses and recovery and rely on shaky sources, speakers at workshop say.
• 10 Ways to Combat Discrimination with Compassionate Language (Depression and Bipolar Support Alliance). Points 8 to 10 are there to guide media. They boil down to: Avoid sensationalizing. Portray people realistically. Don't assume mental health is a factor in violent crime. "The rising number of mass shootings in our country pose particular challenges for the mental health community. More often than not, early reporting of these events either insinuates or states outright that the shooter has or most likely has a mental health condition when there is no or questionable substantiation. As a result, the misperception is created and perpetuated that people with mental health challenges are dangerous. In truth, they are significantly more likely to be victims of violence than perpetrators; only four percent of violent crimes are enacted by people with a mental health diagnosis. The Associated Press (AP) Guide describes a thoughtful approach to reporting this situation. "
• When Someone You Love Has a Mental Illness by Rebecca Woolis
• I Am Not Sick, I Don't Need Help! How to Help Someone with Mental Illness Accept Treatment by Xavier Amador. "Dr. Amador's research on poor insight was inspired by his attempts to help his brother Henry, who developed schizophrenia, accept treatment. Like tens of millions of others diagnosed with schizophrenia and bipolar disorder, Henry did not believe he was ill. In this latest edition, 6 new chapters have been added, new research on anosognosia (lack of insight) is presented and new advice, relying on lessons learned from thousands of LEAP seminar participants, is given to help readers quickly and effectively use Dr. Amador s method for helping someone accept treatment." (To LEAP: "Listen, Empathize, Agree, and Partner -- and help your patients and loved ones accept the treatment they need."
• How to Make Stress Your Friend (Kelly McGonical, TED talk, June 2013) Watch or read.
• The Coddling of the American Mind (Greg Lukianoff and Jonathan Haidt, The Atlantic, Sept. 2015) In the name of emotional well-being, college students are increasingly demanding protection from words and ideas they don’t like. Here’s why that’s disastrous for education—and mental health. For example, some students have called for warnings that Chinua Achebe’s Things Fall Apart describes racial violence and that F. Scott Fitzgerald’s The Great Gatsby portrays misogyny and physical abuse, so that students who have been previously victimized by racism or domestic violence can choose to avoid these works, which they believe might “trigger” a recurrence of past trauma. The new climate is slowly being institutionalized, and is affecting what can be said in the classroom, even as a basis for discussion or debate. What are we doing to our students if we encourage them to develop extra-thin skin just before they leave the cocoon of adult protection?At the end is an interesting list of Common Cognitive Distortions.
• A ‘Bright Light,’ Dimmed in the Shadows of Homelessness (Benjamin Weiser, NY Times, 3-3-18) Nakesha Williams resisted help from social workers, friends and acquaintances, some who only knew her as a homeless woman, and others who knew of her past. "Over the course of more than a year, I delved into Nakesha’s life, trying to understand the events and forces that put her and so many of the city’s homeless on the street....My effort revealed a deeply complicated, at times contradictory, journey — a life of spectacular promise undone by demons. No simple answer to the puzzle of Nakesha emerged. But at the same time, another narrative revealed itself: a story of New Yorkers and others who went to extraordinary lengths to try to help her, only to be left frustrated."
• The Americanization of Mental Illness (Ethan Watters, NY Times Magazine, 1-8-10) "Mental-health professionals in the West, and in the United States in particular, create official categories of mental diseases and promote them in a diagnostic manual that has become the worldwide standard. 'As Western categories for diseases have gained dominance, micro-cultures that shape the illness experiences of individual patients are being discarded,' Lee says. 'The current has become too strong.'” There's an interesting review of this article in Panic!, a blog about panic, anxiety, depression, and related topics.
Approaches to treatment
• Black Therapists Fight to Be Seen on TikTok. When They Are, They Find Solidarity. (Hannah Norman, KHN, 3-23-22) "Black mental health therapists talk openly on TikTok about working in a predominantly white field, while at the same time making mental health care more accessible for people of color who might be shut out of the health care system.... Especially for older generations, Breland-Norton said, people have adapted a disease model of mental health, in which seeking help meant that there is “something wrong with you.” But the mindset has shifted, propelled by millennials and Gen Z, toward a wellness model without the same stigma attached."
• The New Science of Mind (Eric R. Kandel, Sunday Opinion, NY Times, 9-6-13) An increasing understanding of the workings of the brain means that psychiatric disorders are increasingly seen as being based in biology. We're learning which disorders are responsive to cognitive behavioral therapy.
• How to Find the Best Therapist for You, According to Mental Health Experts (Kaitlyn Pirie, Good Housekeeping, 3-18-2020)
• Psychology Today's Find a Therapist tool
• Maybe You Should Talk to Someone: A Therapist, HER Therapist, and Our Lives Revealed by Lori Gottlieb, who also writes Dear Therapist, a regular column in the Atlantic. See her TED Talk "How changing your story can change your life" and listen to her podcast.
• When ‘Not Guilty’ Is a Life Sentence (Mac McClelland, NY Times Magazine, 9-27-17) What happens after a defendant is found not guilty by reason of insanity? Often the answer is involuntary confinement in a state psychiatric hospital — with no end in sight. (Do read the comments as well as the article.)
• Ten Sessions (This American Life, episode 682) Cognitive processing therapy (CPT) is a short-term therapy for trauma designed for survivors of sexual assault and is also used for veterans with PTSD symptoms. Instead of talking for years, you get through all the treatment in just 10 or 12 sessions, in two weeks. This program is drawn from actual therapy sessions for Jaime Lowe, a writer and reporter who was sexually assaulted at age 13, thirty years earlier, who works here in a crash program with Dr. Debra Kaysen, a psychologist who specializes in trauma therapy. They begin by examining Jaime's beliefs, or stuck points (which are not rational and have emotional consequences). An excellent, possibly helpful listen for survivors of trauma (or friends and family). See also Cognitive Processing Therapy (CPT) (Clinical Practice Guidelines for Posttraumatic Stress Disorder, American Psychological Association). "CPT is a specific type of cognitive behavioral therapy that helps patients learn how to modify and challenge unhelpful beliefs related to the trauma." CPT "is a specific type of cognitive behavioral therapy that has been effective in reducing symptoms of PTSD that have developed after experiencing a variety of traumatic events including child abuse, combat, rape and natural disasters."
• With Short, Intense Sessions, Some Patients Finish Therapy in Just Weeks (Andrea Petersen, Ny Times, 8-13-18) A new wave of concentrated, intensive therapy programs for psychiatric disorders "is gaining popularity in part because of new research showing that for both adults and children, the concentrated approach is generally just as effective, and in some ways more effective, as treatment that is spread out over several months" -- "with remission rates of 54 percent for children in intensive, concentrated cognitive behavioral therapy (C.B.T.) for anxiety disorders and 57 percent for those in standard C.B.T., a difference that was not statistically significant." Examples in this story include patients with OCD, PTSD, phobias, anxiety disorder, panic disorder, and separation anxiety.
• Artist Describes How Art Saved Her Life (Lynne Lamberg, Psychiatric News, 9-15-17) Yayoi Kusama draws inspiration from lifelong hallucinations and fears. Art helps her fight extreme anxiety. Fascinating story.
• The Psychiatric Drug Crisis (Gary Greenberg, New Yorker, 9-3-13) What happened to psychiatry's magic bullets? "Having been discovered by accident, they lacked one important element: a theory that accounted for why they worked (or, in many cases, did not). That didn’t stop drug makers and doctors from claiming that they knew....Bedazzled by the prospect of unraveling the mysteries of psychic suffering, researchers have spent recent decades on a fool’s errand—chasing down chemical imbalances that don’t exist."
• Interventions to Prevent Psychosis (Jane E. Brody, NY Times, 9-2-19) An impending psychotic break can be identified and prevented if it is recognized early and appropriate steps are taken to head it off.
• Long-Term Effects Of Psychotropic Drugs Are 'Cloaked in Mystery' (Terry Gross, Fresh Air, 2-27-18) Terry interviews Lauren Slater about her book Blue Dreams: The Science and the Story of the Drugs that Changed Our Minds. Her goal was to explain various drugs strengths, flaws, controversies, and long-term negative effects--she realizes that certain specific drugs allowed her to live a normal life but also have eradicated her libido, caused her diabetes, and probably shortened her life. "As a nation we are gobbling them down and we don't really know what they are doing to our bodies. They are cloaked in mystery. I wanted to remove the mystery." CDC says 23 percent of women are on anti-depressants. Are we being given drugs because doctors prescribe them over-easily? Worth a listen for people taking drug to treat mental health problems.
• Mind Over Misery (Robert L. Strauss, Stanford magazine, Sept/Oct 2013) Psychiatrist David Burns wants people to reason their way through anxiety and depression into happiness. A persuasive account of the effectiveness of cognitive behavioral therapy (CBT) for depression.
• Mental Health (Making Evidence Matter) Approximately 60% of Canadians with mental illnesses do not receive treatment. The treatment rate for addictions is even lower. “The tragedy is not that so many people struggle with mental health problems; the tragedy is that we are still not able to make available to everyone who needs them the services and supports that we know are effective.” (quoting Michael Kirby, former senator and chair of the Mental Health Commission of Canada) But treatment is only part of the solution. Reducing the burden of mental illnesses and addictions on individuals, and Canada as a whole, requires the right balance of funding for promotion, prevention, treatment and rehabilitation. Also, improving social, environmental, and financial supports for people with mental illnesses and addictions will improve their chances of recovery. Links to evidence-based material on addressing mental health problems.
• The Linden Method (for dealing with anxiety, panic attacks, OCD, and phobias)
• Wise Buy? Repetitive Transcranial Magnetic Stimulation (Paul Raeburn, Medpage Today, 2-12-16) Cheaper and safer than ECT, the other proven therapy for refractory depression." With rTMS, "the prefrontal cortex is stimulated with a magnetic field -- rather than an electrical shock. The shape of the field can be controlled so it's confined to where it's needed, eliminating the side effects of ECT." A clear look at the pros and cons of this new treatment.
• People Fighting Depression Discover Little-Known Treatment (Carol Gentry, Health News Florida, 3-3-16) An outpatient treatment for severely depressed patients who get no relief from drugs or talk therapy is becoming increasingly available and affordable: Repetitive Transcranial Magnetic Stimulation (TMS) could help many of the patients who remain trapped by major depression even after trying a whole menu of antidepressants, psychiatrists say.
• Depression: The Current Approach (Rita Rubin, Bethesda Magazine, Jan.-Feb. 2014)
• The placebo effect and the diagnosis effect Transcranial magnetic stimulation was ‘a magical curiosity’ when it was first used to study the human motor system. Now, some scientists regard it as a promising new treatment for patients who don’t respond to antidepressants.
• You Have a Split Personality by Raymond Abbott (Pulse, 11-13-15) As a social worker, Abbott stumbled on an approach that worked with one particularly difficult client.
• The Therapeutic Science Of Adult Coloring Books: How This Childhood Pastime Helps Adults Relieve Stress (Dana Dovey, Medical Daily, 10-8-15) Like meditation, coloring allows us to switch off our brains from other thoughts and focus on the moment. Tasks with predictable results, such as coloring or knitting, can often be calming...“The most amazing things occurred — we started seeing changes in heart rate, changes in brainwaves"...
• The Power of Nothing (Michael Specter, New Yorker, 12-12-11) Could studying the placebo effect change the way we think about medicine? Wayne Jonas: "We try to identify drugs that will eliminate disease. Yet the way we go about delivering those agents—the interaction between doctor and patient, for example—often has a bigger impact than the agent we focus on. More than the drug and more than the surgery. And that has been collectively called the placebo effect.”
• For LSD, What A Long Strange Trip It's Been (Angus Chen, Shots, Health, NPR, 12-16-17) Video and article.
"Psychedelic drugs are getting a makeover, with scientists exploring their potential in treating debilitating conditions like cluster headaches, addiction or anxiety, with promising results. That's despite the fact that very few researchers are legally allowed to study psychedelics, largely because of LSD's decades-old reputation as a counterculture drug that sparked bad trips."
• To Treat Depression, Drugs or Therapy? (Richard A. Friedman, Well, NY Times, 1-8-15) "Dr. Helen Mayberg, a professor of psychiatry at Emory University, recently published a study in JAMA Psychiatry that identified a potential biomarker in the brain that could predict whether a depressed patient would respond better to psychotherapy or antidepressant medication....Is the nonspecific nature of talk therapy — feeling understood and cared for by another human being — responsible for its therapeutic effect? Or will specific types of therapy — like C.B.T. or interpersonal or psychodynamic therapy — show distinctly different clinical and neurobiological effects for various psychiatric disorders? Right now we don’t have a clue, in part because of the current research funding priorities of the National Institute of Mental Health, which strongly favors brain science over psychosocial treatments. But these are important questions, and we owe it to our patients to try to answer them."
• Mindfulness with Jon Kabat-Zinn (YouTube, 1 hour) Learn about Mindfulness-Based Cognitive Therapy (MBCT), apparently useful for treating depression in some patients. See also Finding an MBCT program and read about three practitioners.
• Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic (Kerry J Ressler and Helen S Mayberg, long public access abstract of fuller article at PMC, 7-8-08) • Two Acres of Hope for Recovering Addicts (Cara Buckley, NY Times, 8-16-09)Renewal Farm is run by recovering addicts and alcoholics from New York City, men whose various addictions, and repeated relapses, have left them sickened and homeless. "They come from the gritty streets, but they grow trendy produce, often for rarefied palates. In this patchwork existence, they do have one constant thread: the knowledge that they are teetering on the brink."
• Magnetic stimulation helps some people with treatment-resistant depression ( Julie Appleby Kaiser Health News and Washington Post, 8-6-12) "While rTMS has ardent supporters, its effectiveness is still debated, and there is little evidence showing how long the results last. The technique has been shown to work better than a placebo, but the proportion of patients who show complete relief ranges widely..."
• Deep Brain Stimulation for Treatment-Resistant Depression: An Expert Interview With Helen S. Mayberg, MD (Medscape Psychiatry, 1-5-06)
• Centra finds success in new depression treatment (Amy Trent, News & Advance, 11-7-14) Judd said Centra waited until more long-term data was available about the treatment and it could be made affordable before, deciding to make the $77,000 purchase and train its staff.
• The Trouble With Tough Love (Maia Szalavitz, Washington Post, 1-29-06) Many anguished parents put their faith in strict residential rehab programs. But lack of government oversight and regulation makes it impossible for parents to thoroughly investigate services provided by such "behavior modification centers," "wilderness programs" and "emotional growth boarding schools." Moreover, the very notion of making kids who are already suffering go through more suffering is psychologically backwards. And there is little data to support these institutions' claims of success. The more important question -- whether tough love is the right approach itself -- is almost never broached.
• A Start for Teens, Troubled Teen Industry: Help or Harm? When looking for treatment options for your troubled teenager, you've likely found wilderness boot camp and therapeutic boarding school programs that advertise residential treatment for defiant and troubled teens. Beware: Not all programs are the same, and many do not provide safe, effective treatment for troubled youth.
• Treatment resistance: a complex problem that requires multiple approaches (Phyllis Hanlon, New England Psychologist). More stories in archives.
• PROBLEM: Added cost for medical patients with treatment resistant major depression SOLUTION: Transcranial magnetic stimulation? (Alison Knopf, Behavioral Healthcare, 12-4-13)
• Brain stimulating therapies (NIMH)
• New Approach to Depression (Roni Caryn Rabin, Well, NY Times, 7-1-13) "An advantage of TMS treatment is that it is not invasive and, unlike medication, appears to have few side effects, just occasional discomfort or mild pain in the scalp at the site of the treatment, or headaches. Few patients drop out of treatment because of the pain, however."
• TMS Relieves Symptoms in Teens With Resistant Depression (Daniel M. Keller, Medscape Multispecialty, 3-10-14)
• How Magnets Can Alter the Brain and Help Depression Symptoms (Stephanie Sy, Everyday Medicine) Powerful, high-tech magnets are helping patients, like 70-year-old Keith, who have severe depression.
“In any given moment we have two options: to step forward into growth or to step back into safety.” ~ Abraham Maslow
Tweet
ADHD, ADD, and other problems with
inconsistent (sometimes hyperfocused) attention
• Coming Into Focus (Carla Ciccone, Harper's Bazaar, 9-5-22) Once thought to primarily affect overstimulated boys, ADHD diagnoses have spiked among adult women. For one writer, coming to terms with her diagnosis later in life has put her past and family history in a new light. "The more I understand about how ADHD works, the more I see it as the primary reason for my many struggles rather than an excuse for them."
• Attention, Please! 7 Drug-Free Concentration Boosters for Writers with ADHD (Maggie Langrick on Jane Friedman's blog, 7-25-24)
#1: Technology can be a blessing and a curse for the attention-challenged. While it’s all too easy to get distracted by social media and the lure of the internet, many apps and tech tools offer support. I use an online virtual co-working space called FocusMate to harness the buddy system while I write. Apps like Freedom and Stay Focused will block all digital distractions, and can also gather data on which ones are most problematic for you.
• Tackling Motherhood...And ADHD (NPR, Tell Me More--listen or read): . As more children are diagnosed with Attention Deficit Hyperactivity Disorder, parents are discovering they have it too. In the U.S., women have become the fastest growing group to be prescribed ADHD medication. In this parenting segment, host Michel Martin speaks with Jennifer Brown and Michelle Suppers — "moms with ADHD" and journalist Brigid Schulte, who wrote about the issue for the Washington Post Magazine. See also Navigating My Son’s A.D.H.D. Made Me Realize I Had It, Too (Heidi Borst, NY Times, 2-25-21) Research shows girls with A.D.H.D. tend to internalize their struggles rather than acting out. Experts say some symptoms, especially in women, are mistaken for other conditions such as mood disorders or depression.
• Adult ADHD Is the Wild West of Psychiatry (Yasmin Tayag, The Atlantic, 4-14-23) The Adderall shortage exposed a troubling gap in how doctors care for the disorder. The Adderall shortage has ended, but the widely used generic versions of the drug, known as amphetamine mixed salts, are still scarce. America has no standard clinical guidelines for how doctors should diagnose and treat adults with ADHD—a gap the CDC has called a “public health concern.” The lack of trained providers opens up the potential for inadequate or even dangerous care.
• Another ADHD Telehealth Prescriber Under Scrutiny (Sophie Putka, Healthcare Investigations, Medpage Today, 9-21-22) The Drug Enforcement Agency (DEA) is making inquiries into telehealth company Done, the Wall Street Journal confirmed. Like its competitor Cerebral, Done took advantage of loosened regulations during the pandemic to begin treating ADHD online, including with controlled substances such as Adderall. Cerebral employees are still being interviewed about whether or not they were pressured to prescribe more stimulants. Another rival, Truepill, Cerebral's partner pharmacy, also announced a temporary hold on prescriptions for Schedule II controlled substances. They also shut down their own ADHD treatment service, called Ahead. A previous story in the WSJ quoted a 2021 internal company report from company leadership that said, "multiple Done providers have specifically expressed a perception of pressure to diagnose ADHD and prescribe stimulants." (See Startups Make It Easier to Get ADHD Drugs. That Made Some Workers Anxious. (Rolfe Winkler and Joseph Walker, WSJ, 3-28-22) Digital companies such as Cerebral and Done seized on looser pandemic rules for prescribing ADHD drugs like Adderall. Some workers said they felt pressure to provide the medications.
• Building social capital is critical for strong relationships. ADHD can get in the way. (Cheryl Maguire, Wellness, WaPo, 2-3-22) "She frequently misplaces important items, runs late or struggles with a disorganized purse — all symptoms of ADHD. She has been labeled a “flake” because she forgets social engagements or to reply to texts....Failure to treat symptoms — such as not paying attention or being disorganized — with medication or counseling, can lead to relationship problems." Resources like Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) and the website “ADDitude” can help people with ADHD and their families or friends.
• ADHD & Us: A Couple's Guide to Loving and Living With Adult ADHD by Anita Robertson.
• The ADHD Brain Processes Rewards & Consequences Differently (Jerome Schultz, ADDitude, 6-19-2020) Traditional carrots and sticks don’t motivate students with ADHD – that much is clear. But the neurological underpinnings behind this behavior still mystify many parents and teachers. Here, understand why the ADHD brain is tough to motivate, and how you can adjust your teaching and/or parenting accordingly.
• Thrive with ADD Bonnie Mincu's blog posts about Breakthrough Solutions for Attention Deficit Disorder Adults.
• Patient Voices: A.D.H.D. (NY Times Health Guide, 5-21-08) The challenges faced by those with A.D.H.D. -- weighing the decision to take stimulant medication, facing those who doubt your disorder and adapting to your symptoms -- are daunting and deeply personal. Here, in their own words, are the stories of adults and children coping with A.D.H.D.
• Nature, Nurture and Attention Deficit (Aliyah Baruchin, NY Times, Health) Expert Q&A with Susan Smalley, whose work has a dual focus: the genetics of attention-deficit hyperactivity disorder and the use of techniques of mindfulness in promoting well-being. The "predisposition to getting a diagnosis of A.D.H.D. has a lot to do with what kind of genetic complement you’re born with, and then how that genetic complement interacts with the environment throughout early development...and childhood." It helps for families to understand the genetics, but "it also helps to hone in on what are the strengths, and how best to manage the weaknesses." See also Mindfulness for Adult ADHD: A Clinician's Guide by Lidia Zylowska and John T. Mitchell. "People who have A.D.H.D. but who do relatively well in school often don’t get diagnosed until later in life, said Lidia Zylowska.
• "You know what's funny about #ADHD? It's the only condition that truly makes you smarter and faster than everyone else, while at the same time, convincing you that you're incredibly stupid and can't do a damn thing. That's what it's like to have ADHD." ~Peter Shankman. Listen to Faster Than Normal, Shankman's ADHD podcast, or read/listen to his book: Faster Than Normal: Turbocharge Your Focus, Productivity, and Success with the Secrets of the ADHD Brain
• Kate Arends' website Wit and Delight offers several essays on practical aspects of ADHD, including
---From Loathing to Loving My Crazy Awesome, Dangerously Fast Brain (10-29-19)
---Living with ADHD: Tips for Managing Distractions (4-15-19)
---A Conversation on ADHD with Dr. Anna Roth (10-23-19)
---It’s Harder to Focus These Days. And No, It’s Not Your Fault. (4-4-19) The most articulate way I’ve read the difference between attention and focus was found on Quora of all places: "Attention means directing your mind from random or undisciplined thinking towards a specific thought (or thoughts) or action (or actions). Focus is attention but focus includes a concentrated form of attention, where tremendous effort is exerted to heighten and enhance the attention given."
•Attention Deficit Hyperactivity Disorder (NIH resource page)
• What Is ADHD? (American Psychiatric Association). Calls ADHD one of the most common mental disorders affecting children and describes symptoms and treatment.
• 12 Principles for Raising a Child with ADHD by Russell Barkley. In brief (PDF of one-page summary). While many women do have depression and anxiety, Dr. Barkley said, "It's just that it's being picked up as the primary problem without looking behind the curtain, so to speak, to see what else might be there that could also be contributing to these difficulties."
• Is It Possible to Outgrow A.D.H.D.? (Cheryl Maguire, NY Times, 11-13-20) The challenges of the diagnosis make it unclear whether the condition is outgrown or simply becomes better managed, experts say.
• Helping Kids With A.D.H.D., and Their Families, Thrive (Perri Klass, NY Times, 4-23-18) Research shows that parents of children with A.D.H.D. are more anxious, more stressed and less confident, and that their marriages may be strained. “When a child has A.D.H.D., the level of independence is delayed compared to peers, and often just day-to-day life becomes more stressful at home,” Dr. Bertin said. “All the little things may be harder.”
• ADHD Parents Medication Guide (PDF, American Academy of Child and Adolescent Psychiatry and American Psychiatric Association). There is another online by APA only (PDF, ADHD Parents Medication Guide, revised July 2013) that seems slightly different. Both have many pages of helpful references.
• A Natural Fix for A.D.H.D. (Richard A. Friedman, Opinion, NY Times, 10-31-14) A positive way of looking at what many view as a medical problem in young people. "...let’s not rush to medicalize their curiosity, energy and novelty-seeking; in the right environment, these traits are not a disability, and can be a real asset."
• The best medicine for ADHD might not be medicine, at least at first (Daniel Griffin, WaPo, 2-23-17) Despite the relentless advertising for meds, and the occasional coercion by school personnel, your young ADHD child may not need Ritalin. At least not yet.
• Honey, Are You Listening? How Attention Deficit Disorder Could Be Affecting Your Marriage by Rick Fowler and Jerilyn Fowler. Helpful if you suspect this could be a problem; even more so if it is.
• Treating ADHD may prevent drug abuse (David Trilling, Journalist's Resource, 7-27-17) Treatment has been available for decades, thanks to drugs like Adderall, an amphetamine, and methylphenidate (often sold as Ritalin). But prescribing pills to children is not without controversy.
A new paper comes down firmly on one side of the debate, looking at how standard ADHD medications may reduce substance abuse: “ADHD Medication and Substance-Related Problems,” (Patrick Quinn, et al., The American Journal of Psychiatry, 2017) A team led by Patrick Quinn of Indiana University hypothesized that ADHD sufferers who receive medication may be less likely to develop substance-abuse problems. People diagnosed with ADHD were about three times more likely to have a substance-related problem than the population at large. ADHD patients who had received treatment were less likely to have a problem than patients who hadn’t.
• Why So Many Women With ADHD Never Get The Help They Need (Erin Stewart, The Establishment, 4-29-16) "I’m lucky to be where I am—because for women with ADHD, finding help can be a particularly steep uphill battle. Girls with ADHD tend not to fit the mold of what ADHD “looks like.” ...There are so many disadvantages to ADHD, but there are gifts that I would never give up, and that I’m glad are only moderated by treatment.
• Treatment of Attention-Deficit/Hyperactivity Disorder in Adolescents: A Systematic Review (Eugenia Chan, et al., JAMA review, 5-10-16) JAMA. 2016;315(18):1997-2008. doi:10.1001/jama.2016.5453
• Listen or read (NPR, Tell Me More): Listeners Relate To Moms Juggling Kids And ADHD. Michel Martin and NPR's Tanya Ballard Brown comb through listener feedback to conversations on Tell Me More's segments about "enhanced interrogation techniques" and parents who manage Attention Deficit Hyperactivity Disorder
• Persistent ADHD Associated With Overly Critical Parents (American Psychological Association, 2-8-16) High levels of criticism over time related to continuation of symptoms, study says
• On Their Own: Creating an Independent Future for Your Adult Child With Learning Disabilities and ADHD -- A Family Guide by Anne Ford with John-Richard Thompson, authors of Laughing Allegra: The Inspiring Story of a Mother's Struggle and Triumph Raising a Daughter With Learning Disabilities
• Listen or Read (NPR): Dealing with ADHD as an Adult (Neal Conan, Talk of the Nation, and guests Robert Jergen, Edward Hallowell, and Patricia Quinn)
• The rise of ADHD diagnoses in young mothers (Claudia M. Gold, Kevin MD, 4-1-14) Medicating exhausted young mothers for ADHD, when their problem may well be situation-related, is a boon to the pharmaceuticals industry but may be harmful to the patient. "Could it be that some very clever people in marketing saw an opportunity, and set about selling 'adult ADHD' to both a general and a professional audience? If so, they have certainly been very successful."
• Straight Talk About AD/HD: A Guide to Attention Deficit/Hyperactivity Disorder for Irish Parents by William K. Wilkinson. See book review by Professor Michael Fitzgerald, who says it is a welcome corrective to a common tendency in Ireland in the 1970s through the early 1990s to attribute ADHD to inadequate parenting and the result of family dynamics. See also Adult Attention Deficit Hyperactivity Disorder: The European Perspective (2-24-14); Kurt Cobain was wrong about the treatment of Attention Deficit Hyperactivity Disorder (2-24-14); Road Traffic Accidents and Adolescent / Adult Attention Deficit Hyperactivity Disorder (2-24-14)
• TotallyADD.com (many tools, tips, resources, articles)
• Driven To Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood by Edward M. Hallowell and John J. Ratey (or, for those who have trouble reading, the small-byte-sized Answers to Distraction. Both available as books on tape. Read an excerpt from their book Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder. The authors, both professionals, also have ADD.
• Classroom seating for children with attention deficit hyperactivity disorder: therapy balls versus chairs. (DL Schillling et al., Am J Occup Ther. 2003 Sep-Oct;57(5):534-41, via PubMed) Not really a study, but worth a try?
• Bright Not Broken Gifted Kids, ADHD, And Autism: Why Twice Exceptional Children Are Stuck and How to Help Them by Diane M. Kennedy and Rebecca S. Banks with Temple Grandin
• The Little Monster: Growing Up With ADHD by Robert Jergen. (Read the preface)
• One Boy's Struggle: A Memoir: Surviving Life with Undiagnosed ADD by Bryan L. Hutchinson
• Untangling the Myths About Attention Disorder (Perri Klass, Health, NY Times, 12-13-10)
• The Myth of the A.D.D. Child: 50 Ways Improve Your Child's Behavior Attention Span Without Drugs Labels or Coercion by Thomas Armstrong. See highlights.
• Get the ADHD Facts You Need to Help Your Child Top 11 ADHD Myths and Facts (Kate Taylor, Lifescript, 11-20-12)
• ADHD Affects Women Differently: What to Look For, How to Fix It (Health.com)
• ADHD After Dark: Better Sex Life, Better Relationship by Ari Tuckman. You'll find links to other helpful books on that same page.
• Is It Really ADHD? Other Conditions with Similar Symptoms
• Creating the Optimal Living Environment for a Child with ADHD (Home Advisor)
• Just Because It Looks Like ADHD Symptoms, Doesn't Mean It's ADHD (Robin Aronson, Babble, 12-27-10)
• What Is the Feingold Diet? (WebMD) The Feingold diet is designed to help kids with symptoms of attention deficit hyperactivity disorder (ADHD), dyslexia, and other learning disabilities. It involves avoiding certain foods (including artificial food colors, fragrances, and sweeteners, and food preservatives BHA, BHT, and TBHQ) and that some people think make symptoms worse. Research about the diet is mixed.
• For some with ADHD, the low rumble of brown noise quiets the brain (Amanda Morris, Wellness, WaPo, 11-14-22) Listening to brown, white, or pink noise could have cognitive benefits for people with ADHD, but experts caution the evidence is still limited.The reason may be related to the persistent, overall level of a brain chemical called dopamine. Higher levels of dopamine may help regulate focus, but persistent dopamine release appears to be lower in people with ADHD. Söderlund theorizes that in people with ADHD, listening to broadband noise somehow causes the brain to mimic the effects of dopamine.
• Who Might Be Included on an ADHD Management Team? (ADHD & You)
Anxiety and phobias
• My Anxiety Disorder Means I Live in Constant Fear of Throwing Up (Jennifer Billock, Good Housekeeping, 8-4-2020) For 25 Years I've Battled Emetophobia, a Fear of Vomiting That Rules My Entire Life. "In reality, I hardly ever vomit at all."
• Why Are More American Teenagers Than Ever Suffering From Severe Anxiety? (Benoit Denizet-Lewis, NY Times Magazine, 10-11-17) 'In a seemingly well-meaning effort to help kids avoid what makes them anxious, administrators actually make anxiety worse. “Anxiety is all about the avoidance of uncertainty and discomfort,” Lynn Lyons explained. “When we play along, we don’t help kids learn to cope or problem-solve in the face of unexpected events.”...Lyons believes in the necessity of 504 plans, and she is in agreement with many of the recommendations of Challenge Success, including later school start times, less homework and more project-based learning. But Lyons worries that too many 504 plans are “avoidance-based and teach zero skills.”...Lyons sees a connection between how some schools deal with anxious students and what she worries is a generation of young people increasingly insistent on safe spaces — and who believe their feelings should be protected at all costs. “Kids are being given some really dangerous messages these days about the fact that they can’t handle being triggered, that they shouldn’t have to bear witness to anything that makes them uncomfortable and that their external environments should bend to and accommodate their needs,” she told me.''
• Scott Stossel’s secret: Atlantic editor revealed his raging anxiety. The reaction surprised him (Joe Heim, WashPost Magazine, 6-22-14)
• Shawn, Allen. Wish I Could Be There: Notes from a Phobic Life — part memoir, part explanation, a beautifully written and fascinating account of Shawn's own anxiety and agoraphobia, and a fine summary of what is known about how we form and can learn to manage anxiety and phobias.
• Seniors With Anxiety Frequently Don’t Get Help. Here’s Why. (Judith Graham, KHN, 3-10-23) Questionnaires used to screen for anxiety may be unreliable for older adults. Only about one-third of seniors with generalized anxiety disorder — intense, persistent worry about everyday matters — receive treatment, despite evidence of links between anxiety and stroke, heart failure, coronary artery disease, autoimmune illness, and neurodegenerative disorders such as dementia. Two categories of drugs — antidepressants known as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) — are typically prescribed, and both appear to help to older adults, experts said. The American Geriatrics Society has warned medical providers not to prescribe benzodiazepines (a class of sedating medications such as Valium, Ativan, Xanax, and Klonopinuse) in older adults, except when other therapies have failed, because they are addictive and significantly increase the risk of hip fractures, falls and other accidents, and short-term cognitive impairments.
• Surviving Stress and Anxiety in College & Beyond (Melissa Cohen, LearnPsychology)
• Promoting Student Mental Health (Friedemann Schaub and Blake LeVine, Accredited Schools Online) Broadly covers anxiety and stress, depression, drug abuse and alcoholism, ADHD, eating disorders, OCD, PTSD, but especially anxiety.
• My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind by Scott Stossel. Here's an excerpt, published in The Atlantic, where he is editor: Surviving Anxiety (The Atlantic, Jan./Feb. 2014) "I've tried therapy, drugs, and booze. Here’s how I came to terms with the nation's most common mental illness." "An astonishing portion of my life is built around trying to evade vomiting and preparing for the eventuality that I might throw up.""Medication has more reliably soothed my anxiety than other forms of therapy have. Yet the case for medication is not at all clear-cut."
• Prozac Nation Is Now the United States of Xanax (Alex Williams, NY Times, 6-10-17) Anxiety has become our everyday argot, our thrumming lifeblood...
• Understanding the Anxious Mind (Robin Marantz Henig, NY Times Magazine, 9-29-09) Some people, no matter how robust their stock portfolios or how healthy their children, are always mentally preparing for doom. They are just born worriers.
• 1 in 5 college students have anxiety or depression. Here’s why (David Rosenberg, The Conversation, 2-9-18)
• Evaluating Anxiety From an Early Age Irene Wielawski interviews Daniel Pine about evaluating generalized anxiety disorder from an early age, NY Times, Expert Q&A, 7-11-08)
• My Turn: Deer in the Headlights (Kovia Gratzon-Erskine, My Little Bird, 11-27-16) Using a trip to the movies as therapy for anxiety disorder.
• My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind by Scott Stossel. "In an age inundated by memoirs and psychic self-help books, My Age of Anxiety is the rare memoir that tells an entirely compelling story and the rare self-help book that really helps. You, and many thousands of readers along with you, will laugh until you cry. —George Scialabba, Bookforum
• Shawn, Allen. Wish I Could Be There: Notes from a Phobic Life — part memoir, part explanation, a beautifully written and fascinating account of Shawn's own anxiety and agoraphobia, and a fine summary of what is known about how we form and can learn to manage anxiety and phobias.
• How Not to Smuggle Weed-Killer Into Canada ( Samantha Edwards, Narratively, 5-14-15) When carcinogenic lawn sprays were outlawed in Ontario, my father’s quest for the greenest patch on the block had me dallying in cross-border smuggling—and helped me get to the bottom of my lifelong anxiety.
• Anxiety Disorders (NIMH)
• Treating and Living with Anxiety (Depression and Bipolar Support Alliance, DBDA)
• Help with Anxiety Disorders (American Psychiatric Association)
• Anxiety, Panic & Phobia Center (Psych Central)
http://psychcentral.com/disorders/anxiety/
• The Linden Method (for dealing with anxiety, panic attacks, OCD, and phobias)
• Anxiety, the excellent NY Times Opinionator series, exploring "how we navigate the worried mind, through essay, art and memoir," including the following:
~A Daughter's Separation Anxiety (Nicole Bokat, Opinionator, NY Times, 4-15-13). "When my father was alive, our relationship was virtually symbiotic. After he was gone, I realized he’d been my antidepressant."
~The Hand That Feeds Us (Sara Hope Anderson, Opinionator, NY Times, 4-20-13). "I was sure the loss of my job was just an unpleasant drizzle on my career parade. I was wrong."
~ For the Anxious, Avoidance Can Have an Upside (Joseph Ledoux, Opinionator, NY Times, 4-7-13)
~A Day in the Life (Adane Byron, Opinionator, NY Times, 3-25-13) Social anxiety. "Getting out of my apartment to go to class should have been simple. But the voices in my head wouldn't let me go quietly."
~Up Here on This Island (Mark Dow, Opinionator, NY Times, 3-13-13) Lessons from a 12-year-old boy who took in the world by his own measure.
~The Last All-Nighter (Kate Miller, Opinionator, NY Times, 3-4-13) " I thought it would fast-track me to adulthood, but what Adderall gave me was nothing compared to what it took away."
• Psilocybin Sessions: Psychedelics could help people with addiction and anxiety (Anderson Cooper, 60 Minutes,10-13-19) Study participants at some of the country's leading medical research centers are going through intense therapy and six-hour psychedelic journeys deep into their minds to do things like quit smoking and worry less. The early results are impressive, as are the experiences of the studies' volunteers who go on a six-hour, sometimes terrifying, but often life-changing psychedelic journey deep into their own minds. For nearly two decades now, Roland Griffiths. and his colleague Matthew Johnson have been giving what they call "heroic doses" of psilocybin to more than 350 volunteers, many struggling with addiction, depression and anxiety. About a third have what they would call a "bad trip," but for most that was key to the experience. In 1970, President Richard Nixon signed the controlled substances act and nearly all scientific research in the U.S. Into the effects of psychedelics on people stopped. It wasn't until 2000 that scientist Roland Griffiths won FDA approval to study psilocybin. "This whole area of research has been in the deep freeze for 25 or 30 years," says Griffiths.
• Compass "Navigating Mental Health Pathways" Currently developing psolocybin therapy for patients with treatment-resistant depression.
Bipolar disorder (manic depressive illness)
• What is bipolar disorder? (6-minute video explanation, Helen M. Farrell, TED-Ed)
• Kay R. Jamison, "An Unquiet Mind: Personal Reflections on Manic-Depressive Illness" (transcript of talk at the University of Virginia, by the author of An Unquiet Mind: A Memoir of Moods and Madness and Touched with Fire: Manic-Depressive Illness and the Artistic Temperament)
• How to Live with Bipolar (Sally Alter, RN) Bipolar Basics • Coping with Bipolar • Depression • Mania • Psychosis • Anxiety • Relationships. The Amazon comments suggest this might be helpful.
• Suspect Molecules Overlap in Autism, Schizophrenia, Bipolar Disorder (Science Update, NIMH, 3-1-18) Shared patterns of gene expression may hold clues to disease processes.
• How a Late-in-Life Bipolar Diagnosis Changed My World (Peter Gerstenzang, AARP, 1-11-19) Getting the right treatment after decades of mental health struggles. "After two weeks my world, which displayed things only in monochrome or blinding colors, began to shimmer gently." (Also available in Spanish.) Join the discussion.
• Marbles: Mania, Depression, Michelangelo, and Me: A Graphic Memoir by Ellen Forney. "Ellen Forney's memoir of her bipolar diagnosis and long pharmacopic trek toward balance is painfully honest and joyously exuberant. Her drawings evoke the neuron-crackling high of mania and the schematic bleakness of depression with deft immediacy. Forney is at the height of her powers as she explores the tenuous line between mood disorders and creativity itself." —Alison Bechdel, author of Fun Home: A Family Tragicomic
• Get help with bipolar disorder (American Psychiatric Association). Helpful links.
• Bipolar Disorder: Diagnosing Mood Disorders in a New Generation (Irene Wielawki, NY Times, Expert Q&A 1-25-08). Wielawki interviews NIMH research psychiatrist Ellen Leibenluft about correctly diagnosing children and teenagers)
• Resilience: Two Sisters and a Story of Mental Illness by Jessie Close with Pete Earley. At a young age, Jessie Close struggled with symptoms that would transform into severe bipolar disorder in her early twenties, but she was not properly diagnosed until the age of fifty. Jessie and her three siblings, including actress Glenn Close, spent many years in the Moral Re-Armament cult. Jessie passed her childhood in New York, Switzerland, Connecticut, Zaire (now the Democratic Republic of Congo), and finally Los Angeles, where her life quickly became unmanageable. She was just fifteen years old. Jessie's emerging mental illness led her into a life of addictions, five failed marriages, and to the brink of suicide. She fought to raise her children despite her ever worsening mental conditions and under the strain of damaged romantic relationships. Her sister Glenn and certain members of their family tried to be supportive throughout the ups and downs, and Glenn's vignettes in RESILIENCE provide an alternate perspective on Jessie's life as it began to spiral out of control. With Pete Earley, she tells of finally discovering the treatment she needs and, with the encouragement of her sister and others, the emotional fortitude to bring herself back from the edge.
• Comedian Maria Bamford Opens Up About Living with Bipolar and Rebuilding Her Life After a Mental Breakdown (Patrick Gomez, People, 7-14-16) In her new hit Netflix show Lady Dynamite, Maria Bamford stars as a comedian rebuilding her life after a devastating mental breakdown and bipolar diagnosis.
• American colonists called him a tyrant. But was King George III really so bad? (David Stewart, Outlook, WaPo review of The Last King of America: The Misunderstood Reign of George III) "Distinguished biographer Andrew Roberts is a man on a mission: to prove that King George III of England was neither a tyrant nor the “royal brute” denounced by pamphleteer Thomas Paine during the American Revolution....This fair-minded portrait also shows the king as a man of narrow vision and modest talents who failed major leadership tests and endured five bouts of madness that were probably caused by bipolar disorder. But not a bloodthirsty despot."
• Defying the Verdict: My Bipolar Life by Charita Cole Brown
• When Bipolar Masquerades as a Happy Face (Richard A. Friedman, Health Essentials, NY Times) Like most diseases, bipolar disorder comes in different shapes and sizes and can be difficult to diagnose. a milder form of mania, called hypomania, is not obvious at all, especially in someone who happens to be temperamentally dramatic and lively. In the same way, dysthymia, hypomania's dark twin, has often been confused with gloomy temperament, when in fact it is a treatable form of low-grade depression. Hypomania is intrinsically pleasurable, it can subtly and sometimes powerfully impair a person's judgment.
• Chris Cornell: When Suicide Doesn’t Make Sense (Julie A. Fast, HuffPost, 5-18-17) How can people who seem to have it all possibly take their lives? To answer this question, we need to better understand suicide as a
"symptom of an illness as well as a symptom that can be quickly triggered. Instead of thinking of suicide as a conscious choice that happens when someone doesn’t want to live anymore, we need to see the other side of suicide....When you don’t have a plan that helps these sudden and inexplicable suicidal thoughts, the resulting suicide can never be explained by what is going on in life. The chemicals win in these situations. The illness wins. It’s not about killing ourselves. It’s about an illness killing us." Fast is author of the book Loving Someone with Bipolar Disorder: Understanding and Helping Your Partner
• Bipolar Mama Lauren Kosher (part of HealthiNation's excellent video series) "Depression is like an epoch sadness...a soul sucker...then you to go the other side: mania...grandiose ideas." You can't focus and you can't get enough sleep, so you are exhausted. "The very few friends I had at the time didn't believe me." Mental health care is not available and affordable to everyone. Lauren advocates for easier healthcare with less shame and stigma for people with mental health disorders. See her blog Bipolar Mama.
• Natasha Tracy (excellent six-part HealthiNation video series about her personal experience figuring out how to live with bipolar disorder). Part of an excellent series from HealthiNation. "I have bipolar disorder. I am not bipolar disorder." Having a regular schedule helps.
• Bipolar Burble (Natasha Tracy's blog on HealthiNation).
• Top 5 Myths about Bipolar Disorder (Natasha Tracy, Bipolar Burble)
• Not Knowing (Nobody, DoubleXScience,5-24-13). There will be a next time, another severe and major depression. Plus a few other problems.
• When My Crazy Father Actually Lost His Mind (Jeneen Interland, NY Times Magazine, 2-21-12) This story about an episode in her father’s debilitating bipolar disorder uses her personal story to highlight deficiencies in a dangerously overburdened, underfunded mental health and criminal justice system.
• The Problem With How We Treat Bipolar Disorder (Linda Logan, New York Times Magazine, 4-26-13 and four days later there were already 418 comments). The doctors could address my symptoms. But they didn't much care about my vanishing sense of self.
• The Not So Secret Life of the Manic Depressive: 10 years on Stephen Fry is still helping to get the message across on mental health (Sally Newall, Independent UK, 2-15-15) A decade after his 2006 documentary, Stephen Fry looked at how attitudes and awareness around mental health have changed.
• When My Crazy Father Actually Lost His Mind by Jeneen Interlandi (NY Times Magazine, 6-22-12). Jail and a restraining order are the family's backup system when involuntary commitment is discouraged, psychiatric facilities are overbooked, judges have received inadequate information, and social and medical systems have been gutted to cut costs. Still, the author's father, in full manic psychosis, is a danger to himself and the family who loves but temporarily fears him. Like many who suffer from bipolar disorder, he refuses medication, insists he is normal, and demands his rights: to be free. The Sunday of its publication this piece has 153 comments.
• Electroboy: A Memoir by Andy Behrman. "Andy Behrman was Superman. He slept three hours a day. He learned new languages in a week. He was a dealer, a hustler and an art forger who made millions. He flew from Geneva to Anguilla then back again to balance out the hot and cold. He gave strangers spontaneous gifts of thousands of dollars from the cash he kept in a refrigerator. Then he was arrested for art forgery, went to prison and soon after that found out he was mad. Following intensive bouts of electric shock therapy, he was cured. No longer Superman, but Electroboy. This is his story." (This book got mixed reviews AS a book, but it does tell the story of bipolar disorder treated successfully with electroshock and the right medication.)
• Hurry Down Sunshine by Michael Greenberg. (memoir of his daughter's first manic episode, at 15, and how her bipolar disorder affects the family)
• Madness: A Bipolar Life and Sane: Mental Illness, Addiction, and the 12 Steps by Marya Hornbacher. "The difference between now and the years when I lived in chaos is that I now have the knowledge, the tools, and the support to handle any kind of challenge, any kind of change."
• Gorilla and the Bird: A Memoir of Madness and a Mother's Love by Zack McDermott
• An Unquiet Mind: A Memoir of Moods and Madnessby Kay R. Jamison. A classic memoir about living with manic depression (including its positive aspects).
• A Brilliant Madness: Living With Manic-Depressive Illness by Patty Duke and Gloria Hochman. Duke tells the story of her manic-depressive illness and its successful treatment, while in alternating chapters medical-writer Hochman explains the facts of the disease and the methods of treatment available in 1992, when the book was published.
• Stress Fracture: A Memoir of Psychosis by Tara Meissner (what its like to experience bipolar disorder)
Borderline personality disorder
• 9 Things You Should Know About Borderline Personality Disorder, From Someone Who Has It (Molly Burford, Allure, 10-8-18) Among them: BPD is an emotional regulation disorder. Because of the stigma associated with our disorder, we can often feel very alone in our struggle. "Through therapy, we can learn healthy coping strategies to deal with our intense emotional arousal." We can have stable, loving relationships — romantic and otherwise." "We are not trying to make you feel bad, and people with BPD aren’t manipulative by nature. Sometimes, we simply lack the skills or coping mechanisms to explain what it is we need."
• Randi Kreger's books come highly recommended by professionals:
---Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder (with Paul T. Mason)
---The Stop Walking on Eggshells Workbook: Practical Strategies for Living with Someone Who Has Borderline Personality Disorder
---The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells
• The Chaos That Borderline Personality Disorder Can Cause (Elizabeth Svoboda, Psychology Today, 9-2-13) Borderline personality disorder cuts a wide swath of destruction. Slowly, the condition is yielding to new understanding—provided patients get the correct diagnosis.
• Dialectical Behavior Therapy (Psychology Today)
• Hallmarks of BPD (borderline personality disorder). See Randi Kreger's blog, Lines from the Border and info about her helpful books and online support communities.. See also Why BPD relationships are so complicated.
Children's mental health
• Are You the Same Person You Used to Be? (Joshua Rothman, New Yorker, 10-10-22) Researchers have studied how much of our personality is set from childhood, but what you’re like isn’t who you are. People have strong, divergent opinions about the continuity of their own selves.
"Try to remember life as you lived it years ago, on a typical day in the fall. Does the self you remember feel like you, or like a stranger? Do you seem to be remembering yesterday, or reading a novel about a fictional character? If you have the former feelings, you’re probably a continuer; if the latter, you’re probably a divider.
"Working prospectively, the Dunedin researchers began by categorizing their three-year-olds. They met with the children for ninety minutes each, rating them on twenty-two aspects of personality—restlessness, impulsivity, willfulness, attentiveness, friendliness, communicativeness, and so on. They then used their results to identify five general types of children."
• To Get Mental Health Help for a Child, Desperate Parents Relinquish Custody (Christine Herman, Side Effects Public Media, KHN original, 1-9-19) To get care for their 12-year-old son’s severe mental illness, Toni and Jim Hoy had to give up custody of him and allow the state of Illinois to care for him. It happens to hundreds, perhaps thousands of children each year. The exact number is unknown because two-thirds of states do not keep track.
• Public Schools Are NYC’s Main Youth Mental Health System. Where Kids Land Often Depends on What Their Parents Can Pay. (Abigail Kramer, The City, and ProPublica, 11-17-22) Most kids labeled as having an “emotional disability” and shunted into public special education schools are Black or Latino, and low income — while wealthier families can secure a completely different outcome from the city’s public education system. In the city’s wealthiest neighborhoods, thousands of parents tap their personal funds to send children to private schools for students with disabilities and then sue the city Department of Education to reimburse them for tuition or other services....
'The city doesn’t publish specific demographic data about students whose expenses are paid this way — commonly known as “Carter cases” after a 1993 U.S. Supreme Court decision, Florence County School District Four v. Carter, that affirmed schools had a duty to reimburse tuition in certain situations.'
See The city is paying for more students with disabilities to attend private school. But is that helping poor families? (Alex Zimmerman, ChalkBeat, 10-28-16)
• When Teens Abuse Parents, Shame and Secrecy Make It Hard to Seek Help (Christine Herman, Side Effects Public Media, KHN, 12-11-19) Most domestic assault offenders are adults, but about 1 in 12 who come to the attention of law enforcement are minors, according to a 2008 study by the U.S. Justice Department. In half of those cases, the victim was a parent, most often the mother. People who are victims of domestic violence are advised to seek help. But when the abuse comes from your own child, some parents have said there is a lack of support, understanding and effective interventions to keep the family safe. A 2017 review of the literature found child-on-parent violence is likely a major problem that’s underreported.
• When Young Minds Cry Out Sandra Dark on the importance of checking out possible mental problems as early in a child's life as possible)
• School-based telehealth brings psychiatry to rural Georgia (Alison Knopf, Behavioral Healthcare, 1-10-13)
• Guide to Understanding the Impacts of Childhood Trauma (Asana Recovery) Signs to look for and steps you can take to help a child recover from a traumatic event.
• Covering Trauma and Public or Private Tragedy (guides for journalists on Writers and Editors site)
• Can You Call a 9-Year-Old a Psychopath? (Jennifer Kahn, NY Times Magazine, 5-11-12) "Currently, there is no standard test for psychopathy in children, but a growing number of psychologists believe that psychopathy, like autism, is a distinct neurological condition — one that can be identified in children as young as 5. Crucial to this diagnosis are callous-unemotional traits, which most researchers now believe distinguish “fledgling psychopaths” from children with ordinary conduct disorder, who are also impulsive and hard to control and exhibit hostile or violent behavior. According to some studies, roughly one-third of children with severe behavioral problems — like the aggressive disobedience that Michael displays — also test above normal on callous-unemotional traits. (Narcissism and impulsivity, which are part of the adult diagnostic criteria, are difficult to apply to children, who are narcissistic and impulsive by nature.)"
• Psychopathy: Children at risk respond differently to laughter (Ana Sandoiu, Medical News Today, 9-30-17) ""Psychopathy is an adult personality disorder. However, we do know from longitudinal research that there are certain children who are at a higher risk for developing psychopathy." Such children exhibit two main personality traits: they are likely to be disruptive and show "callous-unemotional traits." In the new study, the researchers screened for these traits and hypothesized that the children displaying them would also be somewhat "immune" to the social contagion that accompanies laughter.
• A Young Immigrant Has Mental Illness, And That’s Raising His Risk of Deportation (Christine Herman, Side Effects Public Media, KHN, 11-26-19) Behavioral problems, criminal arrests and limited access to health care leave a father worried his 21-year-old son will be deported to Mexico.
• Callous-Unemotional Traits in Children (Essi Viding, Observer, Association for Psychological Science, Oct. 2013) Researchers identify link to severe and violent antisocial behavior
• Attachment: It Takes Two (at least) (PDF, Dr. Joyce Maguire Pavao. From her website. See also Seven Core Issues in Adoption and other stories helpful with adopted children.
• Acquainted with the Night: A Parent's Quest to Understand Depression and Bipolar Disorder in His Children by Paul Raeburn
• Bipolar Disorder: Diagnosing Mood Disorders in a New Generation (Irene Wielawki, NY Times, Expert Q&A 1-25-08). Wielawki interviews NIMH research psychiatrist Ellen Leibenluft about correctly diagnosing children and teenagers)
Cutting and self-harm
• A D.C. Teen's Tale of Self-Cutting and Recovery (Kavitha Cardoza, Metro Connection, NPR, 1-23-15) "Research suggests that cutting is more common among teen girls than boys, and it’s quite prevalent — it affects between 12 and 25 percent of adolescents."
• Self-injury/cutting (Mayo Clinic) Self-injury, also called self-harm, is the act of deliberately harming your own body, such as cutting or burning yourself. It's typically not meant as a suicide attempt. Rather, self-injury is an unhealthy way to cope with emotional pain, intense anger and frustration."
• Cutting and Self-Harm: Warning Signs and Treatment (Web MD)
• How shock therapy is saving some children with autism (Apoorva Mandavilli, Spectrum, Oct. 16, 2016) Given its reputation, the most shocking thing about electroconvulsive therapy might be how beneficial — and banal — it actually is. From description for AHCJ award: "The term "electroconvulsive therapy" conjures the infamous scene with Jack Nicholson from the movie "One flew over the Cuckoo's nest," or similar such brutal scenes from popular culture. But this reputation is seriously outdated. More importantly, it belies a procedure that is in fact mostly benign and enormously helpful to people who are severely depressed or suicidal. This article is about a new use for ECT: treating children with autism who harm themselves repeatedly, sometimes to the point of blindness or death. Right now, there are fewer than 50 children with autism who are being treated with ECT, but for these children, ECT is a desperately needed life-saving treatment, say the children's parents and the psychiatrists who administer the therapy."
Depression
including Seasonal affective disorder (SAD)
"The opposite of depression isn't happiness, but vitality."
~Andrew Solomon, The Noonday Demon
• There’s a new pill for postpartum depression, but many at-risk women face hurdles (Nada Hassanein, Stateline, 1-11-24) The first approved drug, brexanolone, also made by Sage Therapeutics, under the brand name Zulresso, costs $34,000 before insurance and requires a 60-hour hospital stay for an IV treatment. Doctors typically must get approval from patients’ health plans before prescribing it, and hospitals must be certified to administer it.
• Depression During or After Pregnancy Linked to Higher Suicide Risk (KFF Health News, 1-12-24)
• What John Fetterman Should Know About Thomas Eagleton (Jeff Greenfield, Politico, 2-17-23) Fifty years ago, the politics of depression upended a career. The times have changed, but Fetterman’s path won’t be easy. Can he find the conditions he needs to heal from depression as a sitting member of the Senate? Does the combination of depression and the fallout from a stroke pose a special set of difficulties? Or can the advances in treating depression, along with a far more accepting climate, mean that, as his office promised, “he will soon be back to himself?”
• A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It? (April Dembosky, KQED and KFF Health News, 3-12-24) "Lawyers, advocates, and regulators are watching closely to see how insurance companies will shape policies for zuranolone because of how some handled its predecessor, an intravenous form of the same drug called brexanolone, which came on the market in 2019. Many insurers required patients to try other, cheaper medications first — known as the fail-first approach — before they could be approved for brexanolone, which was shown in early trials reviewed by the FDA to provide relief within days. Typical antidepressants take four to six weeks to take effect.
"Most health plans have yet to issue any guidelines for zuranolone, and maternal health advocates worry that the few that have are taking a restrictive approach. Some policies require that patients first try and fail a standard antidepressant before the insurer will pay for zuranolone. In other cases, guidelines require psychiatrists to prescribe it, rather than obstetricians, potentially delaying treatment since OB-GYN practitioners are usually the first medical providers to see signs of postpartum depression.
"Most private health insurers "have yet to publish criteria for when they will cover it, according to a new analysis of insurance policies. The lack of guidance could limit use of the drug, which is both novel — it targets hormone function to relieve symptoms instead of the brain’s serotonin system, as typical antidepressants do — and expensive, at $15,900 for the 14-day pill regimen."
"With brexanolone, which was priced at $34,000 for the three-day infusion, California's largest insurer, Kaiser Permanente, had such rigorous criteria for prescribing it that experts said the policy amounted to a blanket denial for all patients, according to an NPR investigation in 2021.
KP's written guidelines required patients to try and fail four medications and electroconvulsive therapy before they would be eligible for brexanolone. Because the drug was approved only for up to six months postpartum, and trials of typical antidepressants take four to six weeks each, the clock would run out before a patient had time to try brexanolone....An analysis by NPR of a dozen other health plans at the time showed Kaiser Permanente's policy on brexanolone to be an outlier. Some did require that patients fail one or two other drugs first, but KP was the only one that recommended four....One month after NPR published its investigation, KP overhauled its criteria to recommend that women try just one medication before becoming eligible for brexanolone."
• How Do You Serve a Friend in Despair? (David Brooks, Opinion, NY Times Magazine, 2-9-23)"If I’m ever in a similar situation again, I’ll know that you don’t have to try to coax somebody out of depression. It’s enough to show that you are trying to understand what this troubled soul is enduring. It’s enough to create an atmosphere in which the sufferer can share her experience. It’s enough to offer him or her the comfort of being seen."
• Pandemic youth mental health toll unprecedented, data show target="_blank"> (Lindsey Tanner, AP, 2-13-23) Sexual violence, suicidal thoughts, suicidal behavior and other mental health woes affected many teens regardless of race or ethnicity, but girls and LGBTQ youth fared the worst on most measures, according to the Centers for Disease Control and Prevention report. More than 17,000 U.S. high school students were surveyed in class in the fall of 2021. In 30 years of collecting similar data, “we’ve never seen this kind of devastating, consistent findings,” said Kathleen Ethier, director of CDC’s adolescent and school health division. “There’s no question young people are telling us they are in crisis. The data really call on us to act.” Almost 15 percent of teen girls said they were forced to have sex, an increase of 27 percent over two years and the first increase since the CDC began tracking it, reported the Washington Post. Girls reported record high levels of sexual violence, sadness and suicide risk.
• I was hospitalized for depression. Faith helped me remember how to live. (Michael Gerson, WaPo, 2-18-19) "At some point, willed cheerfulness fails. Or we skim along the surface of our lives, afraid of what lies in the depths below. It is a way to cope, but no way to live. I’d urge anyone with undiagnosed depression to seek out professional help. There is no way to will yourself out of this disease, any more than to will yourself out of tuberculosis."
• Virginia dementia registry project poised to become state law (Meghan McIntyre, Virginia Mercury, 3-19-24) “This is a lifespan perspective problem,” Rhodes continued. “Finishing high school, living in a place that doesn’t have air pollution, having access to hearing aids, having access to mental healthcare — all of these really complex factors go into preventing dementia and even to symptom reduction.” ..."The project tracks the number of caregivers available to those with dementia, which Staton said is another issue that needs more attention, as they can be difficult to access. Staton said caregiving can be like a full time job, yet around 83% of caregivers are unpaid family members. The problem, she said, is compounded when adding in the stigma that family members may have about the disease."
• A Depression Switch? (David Dobbs, NY Times Magazine, 4-2-06) Deanna Cole-Benjamin never figured to be a test case for a radical new brain surgery for depression. Her youth contained no traumas; her adult life, as she describes it, was blessed. "It began with a feeling of not really feeling as connected to things as usual," she told me one evening at the family's dining-room table. "Then it was like this wall fell around me. I felt sadder and sadder and then just numb." Finally, Deanna's psychiatrist was asked if he had an appropriate candidate for a clinical trial of a new, experimental surgery for treatment-resistant depression--a new, experimental surgery for treatment-resistant depression that involves planting electrodes in the center of the brain
• What is depression? (Helen M. Farrell, TedEd) Depression is the leading cause of disability in the world; in the United States, close to ten percent of adults struggle with the disease. But because it’s a mental illness, it can be a lot harder to understand than, say, high cholesterol. Helen M. Farrell examines the symptoms and treatments of depression, and gives some tips for how you might help a friend who is suffering.
• Depression in Older Adults: Key Issues (Evidence-Based Practices Kit) (SAMHSA,Substance Abuse and Mental Health Services Administration)
• The gift of depression and mood disorder (Sarah Boon, DoubleXScience, 7-26-13)
• Statement of Congressman Jamie Raskin and Sarah Bloom Raskin on the Remarkable Life of Tommy Raskin (Rep. Jamie Raskin, Medium, 1-6-2021) "Tommy Raskin had a perfect heart, a perfect soul, a riotously outrageous and relentless sense of humor, and a dazzling radiant mind. He began to be tortured later in his 20s by a blindingly painful and merciless ‘disease called depression,’ as Tabitha put it on Facebook over the weekend, a kind of relentless torture in the brain for him, and despite very fine doctors and a loving family and friendship network of hundreds who adored him beyond words and whom he adored too, the pain became overwhelming and unyielding and unbearable at last for our dear boy, this young man of surpassing promise to our broken world."
• Mike Wallace's Battle With Depression and Suicide (Mikaela Conley, ABC News, 4-9-12) When Wallace's wife Mary asked whether her husband could be suffering from clinical depression, the doctor reportedly told the couple, "Forget the word 'depression' because that'll be bad for your image." At his lowest and most desperate, a bottle of pills and a suicide note seemed like the only answer for the legendary journalist Mike Wallace.
• Depression Hates a Moving Target: How Running With My Dog Brought Me Back From the Brink by Nita Sweeney
• Depresh Mode with John Moe (Maximum Fun podcast).Honest, humane conversations with top artists, entertainers, and experts about what it’s like to live with an interesting mind. No shame, no stigma, and more laughs than you might expect from a mental health podcast. Moe is author of the book The Hilarious World of Depression.
• Gary Gulman: The Great Depresh | A Conversation About Depression (exclusive full HBO clip, 10-18-19) To celebrate the premiere of The Great Depresh, Gary Gulman joined executive producer Judd Apatow and comedians Maria Bamford and Patton Oswalt for a benefit show and Q&A benefiting Didi Hirsch Mental Health Services at Largo in Los Angeles. Yes, comedians get depressed.
• Seasonal Affective Disorder (SAD) National Institute of Mental Health, NIMH.
• Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial by Allison Bass. "Bass focuses on psychiatrist Martin Teicher, who as early as 1988 noticed that the antidepressant Prozac seemed paradoxically to cause suicidal thoughts in his patients, and the nearly blind Rose Firestein, a lawyer in the New York State attorney general's office who was investigating the inappropriate marketing and use of Paxil for unapproved purposes. Drug companies insisted there was no scientific evidence whatsoever linking GlaxoSmithKline's Paxil, Ely Lilly's Prozac and other serotonin-increasing antidepressants to suicidal thoughts and behavior, and Bass describes the dogged battle to show that company researchers had deliberately suppressed the results of trials with negative outcomes."
• 79 Resources for Managing Seasonal Affective Disorder (Public Health Degrees)
• Shining a light on winter depression (Harvard Health) Light therapy can help you avoid seasonal affective disorder.
• Learning How to Cope With Seasonal Affective Disorder (David Rosenberg, Slate, 1-14-15) Illustrated.
• Will That Antidepressant Work For You? The Answer May Lie In Your Brain Waves (Jon Hamilton, Shots, All Things Considered, 2-10-2020) A study of more than 300 people with major depression found that brain wave patterns predicted which ones were most likely to respond to the drug sertraline (Zoloft). The results suggest depression treatment doesn't have to rely on trial and error. "By finding people who are particularly sensitive to an antidepressant, we can find those people for whom the drug is very effective," says Dr. Amit Etkin, CEO of a Stanford-backed start-up developing computer-based approaches to diagnosing mental illness and selecting treatments.
• What To Do When You're Depressed (Steven Skoczen, InkandFeet.com) Steven is writing The No-Bullshit Guide to Depression.
• Why Postpartum Depression Is Even Harder When You're Not White (Pooja Makhijani, BuzzFeed, 12-7-15) Five women talk about why it's so hard for new parents of color to get the treatment they need for postpartum depression and other mood disorders, and how to make it better.
• Suicide Crisis. Can the rising rate be stemmed? (Christina Lyons, CQ Researcher, 7-12-19. Subscription required). 'Suicide survivors are, in varying degrees, “disconnected from health care,” because so many have had a negative experience with doctors, says David A. Jobes, director of the Suicide Prevention Laboratory at The Catholic University of America in Washington, D.C. He says he hopes “the peer support movement may capture someone who would never see a person like me.”' Resources Lyons cites (among many others):
---NowMattersNow.org ("a website that provides free suicide prevention resources along with stories from individuals who have recovered from suicidal thoughts after receiving treatment called dialectical behavior therapy, or DBT")
---LiveThroughThis.org. Dese'Rae Stage posted her story and invited others to share theirs. “LiveThroughThis is lifting up a marginalized community — one that's never been given a voice … and [has had] stereotypes heaped on it,” Stage says.
---“Ketamine Could Be the Key to Reversing America's Rising Suicide Rate” (Cynthia Koons and Robert Langreth, Bloomberg BusinessWeek, 2-5-19) "A new nasal spray from Johnson & Johnson is the first drug based on the anesthetic ketamine that has won Food and Drug Administration approval for patients who do not respond to traditional antidepressants."
---Understanding Links among Opioid Use, Overdose, and Suicide (Amy S.B. Bohnert and Mark A. Ilgen, New England Journal of Medicine, 1-3-19) "Two University of Michigan researchers report that deaths from suicide and unintentional drug overdose more than doubled in the United States between 2000 and 2017, and that both problems are connected with pain and opioid use."
---Connecticut’s ‘red flag law’ was the first in the nation. Twenty years later, it’s saved many lives. (Mike Lawlor, Hartford Courant, 6-28-19) "Connecticut's red flag law has prevented dozens of suicides and likely many murders since it was implemented in 1999, says the state's former undersecretary for criminal justice policy and planning." Red flag laws are "designed to keep guns out of the hands of people who could pose a threat of suicide or violence."
---When Social Media Is Really Problematic for Adolescents (Perri Klass, NY Times, 6-3-19) Underlying problems may make some young people particularly vulnerable to what they find on social media, an expert says. (A 'must read' for parents and adolescents).
• F.D.A. Panel Recommends New Depression Treatment (Benedict Carey, NY Times, 2-12-19) In a move that may clear the way for the first new treatment in years for depression, an expert panel recommended on Tuesday that federal regulators approve a nasal spray that delivers the active ingredients of ketamine, a popular club drug in the 1980s and 1990s. The new drug, called Esketamine and developed by Johnson & Johnson, is aimed at people with severe depression, particularly those with suicidal thinking. The panel, with 17 voting members, including psychiatrists and consumer representatives, was nearly unanimous in deciding that the drug’s benefits outweighed its risks. The FDA usually follows the recommendations of its expert panels. If approved, the drug would be covered by insurance. Until then, the drug is expensive and treatments are "off-label" and not covered by insurance.
• This Is the Problem With Casually Using the Word 'Depressed' (Jane Roper, WBUR, 5-29-18) When you’re really sad, you might not feel like getting out of bed. When you’re clinically depressed, you can’t....The problem with people casually using the term “depressed,” as a catch-all for unhappiness is that it perpetuates misunderstanding and stigma around major depression — which too many still view as a result of weakness, laziness or a character flaw.
• Confessions of a Depressed Comic (Kevin Breel, TED Talks, Sept. 2013) Kevin Breel didn't look like a depressed kid: team captain, at every party, funny and confident. But he tells the story of the night he realized that -- to save his own life -- he needed to say four simple words. See also Video playlists of TED talks about Depression and more audio TED Talks on depression.
• How To Help Someone With Depression (Steven Skoczen, InkandFeet.com) The best ways to help someone with depression and why they work.
• Therapy Didn’t Rid Me Of My Depression. But It Helped Me Understand It (Susan Cheng, Medium, 5-31-17) It’s true when they say pains that don’t get discussed aren’t perceived as important or even real to the rest of the world.
• 1 in 5 college students have anxiety or depression. Here’s why (David Rosenberg, The Conversation, 2-9-18)
• Depression: Start healing by telling your story (YouTube video of Richard Rauser talking about depression). Along the right side are links to more videos about depression.
• Patients who have had suicidal thoughts are often excluded from antidepressant trials. The FDA says they don’t need to be (Megan Thielking, STAT, 6-18-18) The Food and Drug Administration is overhauling its guidance for developing treatments for major depressive disorder for the first time since 1977 — and this time around, it’s making clear that patients with a history of suicidal thoughts or behaviors can be included in clinical trials.
• Journalists Offer Sharply Divergent Views of Brain Implants for Depression (John Horgan, Scientific American,4-23-18) One reporter emphasizes the promise of an experimental treatment (deep-brain stimulation (DBS), which delivers electrical pulses to specific neural regions via implanted electrodes), another the peril.
• Why a 'Lifesaving' Depression Treatment Didn't Pass Clinical Trials... but could still be a groundbreaking therapy (David Dobbs, Science, 4-17-18) Dobbs looks at what a given clinical trial can and cannot tell us, and what it means when one fails. "Some medical experiments are more daunting than others. The one that the neurologist Helen Mayberg came up with to test a model of depression she had developed over about 15 years involved drilling two holes in the top of a patient’s skull and sliding two low-voltage electrodes deep into the brain until they reached a region known as Brodmann area 25." [Deep brain stimulation, or DBS] The results varied greatly, but the treatment (extremely expensive) was lifesaving for some. "What we have here is a failed clinical trial—of a treatment that seems to work....Cast in terms of a courtroom trial, then, the halt of almost any clinical trial—and clearly this one—declares not a verdict but a mistrial. The question at hand remains unresolved, to be answered another day. Both Mayberg’s treatment and her wider hypothesis must still prove themselves. But the Broaden trial has hardly proven them wrong." See also What does it mean when a clinical trial fails? Probably not what you think. (David Dobbs, Neuron Culture, 4-17-18) In 2006, when Dobbs "first wrote about neurologist Helen Mayberg’s innovative and rather radical depression treatment— the insertion of two humming electrodes deep into the brain... it was being hailed as the most promising advance in depression treatment in decades." In 2013 the trial was halted. Why did the trial of such a promising treatment fail, though it had clearly helped some patients? What did it mean that it had? <
• Adventures in Depression (Hyperbole and a Half, 2011) Cartoon story: Some people have a legitimate reason to feel depressed, but not me. I just woke up one day feeling sad and helpless for absolutely no reason
• How I Learned To Be OK With Feeling Sad (Mac McClelland, Buzzfeed, 2-20-15) It wasn't easy, or cheap.
• Can Preschoolers Be Depressed? (Pamela Paul, NY Times Magazine, 8-29-10) Today a number of child psychiatrists and developmental psychologists say depression can surface in children as young as 2 or 3. br />• Depression's Upside (Jonah Lehrer, NY Times Magazine, 10-28-10) "Why is mental illness so closely associated with creativity? Neuroscientist Nancy Andreasen argues that depression is intertwined with a “cognitive style” that makes people more likely to produce successful works of art. In the creative process, Andreasen says, “one of the most important qualities is persistence.” Based on the Iowa sample, Andreasen found that “successful writers are like prizefighters who keep on getting hit but won’t go down. They’ll stick with it until it’s right.”..."This is the paradox of evolution: even if our pain is useful, the urge to escape from the pain remains the most powerful instinct of all."
• How Electroshock Therapy Changed Me (Sherwin Nuland, TED2001, video with transcript). " I am a man who, almost 30 years ago, had his life saved by two long courses of electroshock therapy....I couldn't get out of bed before about 11 o'clock. And anybody who's been depressed here knows what that's like. I couldn't even pull the covers off myself."
• Cut Off (Elaine Vitone, PittMed, Summer 2017) Lisa Pan (University of Pittsburgh Res ’03, Res ’05, Fel ’08) began her research career studying neuroimaging markers of suicide risk in young people. Under the wing of David Brent, arguably among the world’s foremost experts on treatment-resistant depression (also called treatment-refractory depression) and suicidal behavior in teens. She and David Finegold, a professor of human genetics in Pitt’s Graduate School of Public Health, examined a lumbar-puncture test (a sampling of cerebrospinal fluid, or CSF) for clues of what was circulating in the central nervous system of Eve, a patient with severe and unrelenting depression. As it turned out, Eve’s CSF level of biopterin, a chemical the body uses to synthesize several neurotransmitters, was through the floor. They started her on a replacement-therapy regimen, and over the next few months, the team observed the gradual return of this long-absent chemical so crucial to the production of serotonin, dopamine, norepinephrine, pain modulators, and melatonin. They recount the profound effect the regimen had on Eve. Expanding the study to 33 young people with treatment-resistant depression, "they found that 64 percent had some form of metabolic deficiency of the central nervous system; controls had absolutely none. And once the patients’ deficiencies were treated, the majority of their symptoms improved. For two of them, depression vanished altogether." Once, someone told Eve her trouble was that she just wasn’t working hard enough in therapy. “And then, you find out she may not be able to make neurotransmitters,” says Pan. In psychiatry, she says, “we’re not so far along yet that we know exactly what we’re treating. . . . When we approach mental illness, we need to keep an open mind about what might be occurring that we don’t understand.”
• Bruce Springsteen Opens Up About Depression In His New Memoir (Tod Perry, Good). The memoir: Born to Run.
• Splintered Doors (Vanessa Martir, The Rumpus, 5-21-18) That day, my daughter gave me permission to do what I hadn’t been given permission to do since I was that little girl, watching that splintered door: grieve.
• 13 Things Men With Anxiety And Depression Want You To Know (Lindsay Holmes, HuffPost, 9-16-15)
• Get help with depression (American Psychiatric Association). Helpful links.
• A Day in the Life of a Psychiatrically Hospitalized Clinician (Liat Katz, Pulse: Voices from the Heart of Medicine, Part 1, 12-18-15) and Part 2, 12-25-15.
• Is depression a kind of allergic reaction? (Caroline Williams, The Guardian, 1-4-15) A growing number of scientists are suggesting that depression is a result of inflammation caused by the body’s immune system
• Why Aren't You Depressed? (Tess Simmes, Pulse: Voices from the Heart of Medicine, 10-6-17)
• The Battle to Belong: Depression and an Immigrant’s Struggle to Assimilate ((Roger Cohen's powerful story about his mother's manic depression and suicide attempts and how they affected the family (NY Times, 1-9-15). Adapted from his memoir, The Girl from Human Street: Ghosts of Memory in a Jewish Family A remarkable chronicle of the quest for belonging across generations. An intimate and profoundly moving Jewish family history—a story of displacement, prejudice, hope, despair, and love.
• Which Anti-Depressant Is Right for You? Your DNA Can Shed Some Light (Lucette Lagnado, WSJ, 5-6-18) McLean Hospital psychiatrists Brent Forester and Ipsit Vahia, are occasionally using genomics to help inform decisions about prescribing anti-depressants. The GeneSight test predicts the effects of more than 50 anti-depressants and anti-psychotics. Based on a patient’s results, drugs are categorized as ones to be avoided, ones that have some drawbacks and ones that can be used “as directed.” An evaluation of the story: Gene test for depression treatment: Realistic patient story helps keep WSJ article grounded (Joanne Rogers, Leah Rosenblum, Elizabeth Russo, HealthNewsReview, 5-10-18) Points out the reality: The Myriad Genetics GeneSight test apparently can improve the chances of getting an effective anti-depressive drug, but the research is all preliminary. See also A Genetic Test Could Help Predict the Right Antidepressant For You (Alice Park, Time, 5-7-18)
• Could Depression Be Caused By An Infection? (Bret Stetka, Shots, NPR, 10-25-15) Turhan Canli's assertion that depression results from infection might seem far-fetched, or at least premature, but there are some data to bolster his claim. Canli notes how certain infections of the brain — perhaps most notably Toxoplasma gondii — can result in emotional disturbances that mimic psychiatric conditions. He also notes that numerous pathogens have been associated with mental illnesses, including Borna disease virus, Epstein-Barr and certain strains of herpes, including varicella zoster, the virus that causes chickenpox and shingles."
• Understanding clinical depression (podcast with Hinda Dubin, psychiatrist with the University of Maryland School of Medicine)
• Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial by Alison Bass. The tale of a gutsy assistant attorney general who, along with an unlikely whistle-blower at an Ivy League university, uncovered evidence of deception behind one of the most successful drug campaigns in history. Paxil was the world's bestselling antidepressant in 2002. Pediatric prescriptions soared, even though there was no proof that the drug performed any better than sugar pills in treating children and adolescents, and the real risks the drugs posed were withheld from the public. The New York State Attorney General's office brought an unprecedented lawsuit against giant manufacturer GlaxoSmithKline, the maker of Paxil, for consumer fraud. The successful suit launched a tidal wave of protest that changed the way drugs are tested, sold, and marketed in this country.
• Fireworks or Brain Zaps? (Jean Pollack, Psychology Today, 7-3-11) While withdrawing slowly from SSRI antidepressant medication, some patients experience a sudden electric buzz sound in their brain especially when resting or sleeping at night, the result of a neurochemical change when decreasing or stopping the medication. They can occur during a dosage adjustment of SSRI and SNRI antidepressant drugs.
• U.S. attorney urged to re-open an investigation into an Allergan unit for alleged fraud (Ed Silverman, STAT, 2-8-18) "Nearly eight years ago, an Allergan (AGN) unit paid $150 million to settle criminal charges of illegally marketing three drugs. Now, the U.S. attorney in Boston is being asked to reopen its investigation after newly unsealed documents suggest the company may have deliberately misled federal officials about a key clinical trial for one of the medicines, undermining the basis for the settlements. Specifically, the documents indicate Forest Laboratories obscured crucial information demonstrating the Celexa antidepressant was not effective in children. Instead, using what its medical director acknowledged was “a masterful stroke of euphemism,” the company portrayed the study results as positive in materials that were submitted to the Food and Drug Administration in hopes of winning approval for pediatric use, according to the court documents."
• What Depression Is Really Like (Maria Popova, BrainPickings, 2-9-16) “The gray drizzle of horror induced by depression takes on the quality of physical pain.”
• Tchaikovsky on Depression and Finding Beauty Amid the Wreckage of the Soul (Maria Popova, BrainPickings, 11-19-15) “Life is beautiful in spite of everything! … There are many thorns, but the roses are there too.”
• Depression is a disease of civilization (Stephen S. Ilardi's TED talk, TEDxEmory, 5-23-13). Ilardi is author of The Depression Cure: The 6-Step Program to Beat Depression Without Drugs He talks about what causes depression, and how to combat it through exercise, Omega-3 Fatty Acids, friendship and more.... Clinical depression shows all the hallmarks of being one of the diseases of civilization (diabetes, atherosclerosis, asthma, allergies, obesity, and many forms of cancer). These are all inflammatory diseases that can trigger an inflammatory reaction throughout the body. The inflamed brain is a depressed brain."
• Thoughtful and thorough, AP story looks at growing trend of using ketamine for depression (Mary Chris Jaklevic, Sally James, and Saurabh Jha, Health News Review) review of Trippy depression treatment? Hopes and hype for ketamine (Lindsey Tanner, AP News, 10-31-18)
• How the worst moments in our lives make us who we are (Andrew Solomon's TED talk 2014 (with a transcript), earlier called "Depression: The Secret We Share." Writer Andrew Solomon "has spent his career telling stories of the hardships of others. Now he turns inward, bringing us into a childhood of struggle, while also spinning tales of the courageous people he's met in the years since. In a moving, heartfelt and at times downright funny talk, Solomon gives a powerful call to action to forge meaning from our biggest struggles."
"When we're ashamed, we can't tell our stories, and stories are the foundation of identity. Forge meaning, build identity. Forge meaning and build identity. That became my mantra. Forging meaning is about changing yourself. Building identity is about changing the world. All of us with stigmatized identities face this question daily: How much to accommodate society by constraining ourselves, and how much to break the limits of what constitutes a valid life? Forging meaning and building identity does not make what was wrong right. It only makes what was wrong precious."
"Forge meaning, build identity, and then invite the world to share your joy."
"The opposite of depression is not happiness, but vitality, and it was vitality that seemed to seep away from me in that moment."
In a talk equal parts eloquent and devastating, writer Andrew Solomon takes you to the darkest corners of his mind during the years he battled depression. That led him to an eye-opening journey across the world to interview others with depression — only to discover that, to his surprise, the more he talked, the more people wanted to tell their own stories. I survived that childhood through a mix of avoidance and endurance. What I didn't know then and do know now, is that avoidance and endurance can be the entryway to forging meaning. After you've forged meaning, you need to incorporate that meaning into a new identity. You need to take the traumas and make them part of who you've come to be, and you need to fold the worst events of your life into a narrative of triumph, evincing a better self in response to things that hurt."See also Vows: Andrew Solomon and John Habich (Eric Pfanner, NY Times, 7-8-07)
• The Noonday Demon: An Atlas of Depression by Andrew Solomon. "Sometimes, the legacy of depression includes a wisdom beyond one's years, a depth of passion unexperienced by those who haven't traveled to hell and back. Off the charts in its enlightening, comprehensive analysis of this pervasive yet misunderstood condition, The Noonday Demon forges a long, brambly path through the subject of depression--exposing all the discordant views and "answers" offered by science, philosophy, law, psychology, literature, art, and history. The result is a sprawling and thoroughly engrossing study, brilliantly synthesized by author Andrew Solomon." (Amazon review)
• Not knowing (Nobody, DoubleXScience, 5-24-13) "I have major depression, severe, recurrent. This diagnosis came 4 months after the best 18 months of my life where I had no depression. And it only came about 6 months ago when I was in the worst depression of my life....I had learned to hide my depression so well that while my mother knew I had it (her work brought her into contact with many severe cases of people with mental disorders) and my spouse knew I had it, no one knew about my suicide attempts or how low I was at any point."
• In despair from major depression, I turned to a last resort: Magnets (Courtenay Harris Bond, Philadelphia Inquirer, 3-14-18) In despair, she was treated by John O'Reardon, a Voorhees psychiatrist who has long seen patients close to giving up."The amount of patients who have severe, what we call treatment-resistant depression, is about four million at any one time in the U.S.," O'Reardon said in an interview. "These are patients who do not respond to medications, who may not respond to therapy, and really need something else. And for those patients, in particular, TMS [transcranial magnetic stimulation] is very useful." A particularly helpful article. See also Transcranial magnetic stimulation (TMS): Hope for stubborn depression (Adam P. Stern, Harvard Health blog, 2-23-18) Transcranial magnetic stimulation, or TMS, is a noninvasive form of brain stimulation. Approximately 50% to 60% of people with depression who have tried and failed to receive benefit from medications experience a clinically meaningful response with TMS.
• Fighting Depression with Magnets (Kasra Zarei, Scientific American, 12-20-17) Transcranial magnetic stimulation isn't a new therapy, but it can be an effective last line of defense against this frequently disabling disorder.
• Furiously Happy: A Funny Book About Horrible Things by Jenny Lawson, a funny and honest (and bestselling) book about Lawson’s struggles with various forms of mental illness — clinical depression, panic attacks, a compulsion to pull out her own hair. See also Lawson's Let's Pretend This Never Happened (a mostly true memoir)
• Brain Stimulation Shows Promise in Treating Severe Depression (Benedict Carey, NY Times, 10-4-19) Years ago, more than two dozen patients received an electrical implant to counter their depression. They’re still feeling better, a new study finds. It was a small study, “The most impressive thing here is the sustained response,” Dr. Darin Dougherty, director of neurotherapeutics at Massachusetts General Hospital, said. “You do not see that for anything in this severe depression."
• Obesity and Depression Are Entwined, Yet Scientists Don’t Know Why (Shefali Luthra, Kaiser Health News, 8-11-17)
• Singleminded (Diana Spechler, Anxiety series, Opinionator, NY Times 6-26-15) "My worst depression comes not from heartbreak, but from feeling trapped. Yet I’ve sought out relationships again and again." See Going Off, a a series of Anxiety posts chronicling Spechler's attempt to wean herself off the medications she takes for depression, anxiety and insomnia.
• The Backcountry Prescription Experiment (Longreads, 12-19) Mathina Calliope goes off her antidepressant and into the woods "...how a break from my meds led, ultimately and circuitously, to another kind of birth; to a different life for myself."
• These Photos Capture The Anguish Of Living With Depression (Lindsay Holmes, HuffPost, 9-14-15) For 21-year-old photographer Edward Honaker, experiencing depression and anxiety felt like being at war with his brain. He reached for his camera to turn his emotions into something tangible. The result is a series of self-portraits that capture his personal experience with depression. "The whole experience made me a lot more patient and empathetic towards others."
• Shameover It's time to talk about men's mental health. Series on HuffPost.
• How It Really Feels To Have Anxiety And Depression, In One Comic (Lindsay Holmes again, HuffPost, 9-17-15) "You can't just "calm down" when you have anxiety or "snap out of it" when you're going through depression. However, many people still don't understand how mental illness occurs, leading to feelings of guilt, shame and isolation in those who experience it."
• A treatment for Parkinson’s disease reveals a brain switch for sadness (Amy Ellis Nutt, WaPo, 3-3-16) An electrical pulse fired into the brain of a patient who'd suffered Parkinson's for 30 years triggered a brief episode of severe depression and sadness -- "when the pulse was on, the woman said she felt as though she was being sucked into a black hole." "The fact that doctors had inadvertently found a source of symptoms for one of the most pernicious of psychological maladies — and in a bit of gray matter no larger than the head of a pin — prompted a singularly bizarre question: Why would depression, which is responsible for so much misery in the world, be hard-wired into the brain?"
• True Champions: Erin Schulthies (mental health advocate Erin, HealthiNation), shares (video, several segments--wait for next to come when one ends) what it has been like to suffer from depression for most of her life. Read also her blog Daisies and Bruises, about finding her way after losing most of her youth to depression.
• The Secret Sadness of Pregnancy With Depression (Andrew Solomon, NY Times Magazine, 5-28-15) Pregnant women often fear taking the antidepressants they rely on. But not treating their mental illness can be just as dangerous. ‘One of the reasons we didn’t really recognize antepartum depression for a long time was because it was easier not to, because it put physicians in such a bind.’
• ‘Thinking of Ways to Harm Her’ (Pam Belluck, NY Times, 6-15-15). New Findings on Timing and Range of Maternal Mental Illness (Mother's Mind. First of two articles.). See also After Baby, an Unraveling (Pam Belluck, NY Times, 6-16-14) A Case Study in Maternal Mental Illness (second of two articles, Mother's Mind.
• Resources on Maternal Mental Illness
• Are Antidepressants Safe During Pregnancy? (Roni Caryn Rabin, Well, NY Times, 9-1-14)
• Does gender play a role in treatment? (Phyllis Hanlon, New England Psychologist, 3-1-15) Excellent discussion, of treating depression generally as well as with a focus on gender.
• All About Depression
• Acquainted with the Night: A Parent's Quest to Understand Depression and Bipolar Disorder in His Children by Paul Raeburn
• The gift of depression and mood disorder (Sarah Boon, DoubleXScience, 7-26-13). What do you do when your illness feeds your success?
• Creative minds: the links between mental illness and creativity (Roger Dobson, The Independent, 5-5-09, reprinted in Beating the Beast: An Online Depression Support Community)
• Depression (Psychology Today blog)
• Depression resources (Psych Central, including material on Seasonal Affective Disorder (SAD))
• Learning How to Cope With Seasonal Affective Disorder (David Rosenberg, Behold, the photo blog, Slate, 1-14-15)
• Hyperbole and a Half (Allie Brosh's wonderful blog, with drawings and great text). Most anyone who has suffered depression will be able to identify with the stories and thoughts expressed partly through drawings/cartoons, with humor. Check out this blog entry in particular, and listen to Brosh on this NPR interview, "Clean ALL the things.". Consider buying a copy of her book: Hyperbole and a Half: Unfortunate Situations, Flawed Coping Mechanisms, Mayhem, and Other Things That Happened...
• Depression. Can Psychiatry Be a Head Case? (Louis Menand, New Yorker story on how little science agrees about the nature of depression and the effectiveness of psychiatric medication, 3-1-10)
• Decades after 2 suicide attempts, I'm thankful to have the life I nearly cut short (Jacquielynn Floyd Dallas News.com, 2-2-13). "For me, depression took on a camouflaged veneer of normal that made it difficult to “read the signals.”
• Depression, Research on (John M. Grohol, NIMH)
Eating disorders
• National Eating Disorders Association (NEDA) (forums and other forms of support)
• Recognizing Eating Disorders in Time to Help (Jane Brody, NY Times, 7-30-18) 'Experts say an eating disorder — anorexia, bulimia or binge-eating — should not be considered “normal” adolescent behavior, and they urge the adults in the youngsters’ lives to be alert to telltale signs and take necessary action to stop the problem before it becomes entrenched.... The problem is especially common among, though not limited to, gymnasts, dancers, models, wrestlers and other athletes, who often struggle to maintain ultra-slim bodies or maintain restrictive weight limits. The transgender population is also at higher risk for eating disorders.'
• Eating Recovery Center
***Patient Voices: Eating Disorders (NY Times Health Guide) How does an eating disorder take over someone’s life? Is it a matter of losing control or trying to seize it? Eight men, women and children tell of their struggles with anorexia, bulimia and other forms of eating disorders. Join the discussion.
• Eating Disorders News (blog of Psychology Today)
• Unhealthy Weight Loss or Gain from Eating Disorders (Pritikin Wellness Resources)
• Netflix Just Released the Eating Disorder Movie We Don’t Need (Ankita Rao, Motherboard, 6-23-17) It's time for pop culture to grasp the realities of this life-threatening mental illness. The disorder itself is not just anorexia: it's binge eating, anxiety, laxative abuse, exercise addiction. It's 13 percent of women over 50 years old. It's 16 percent of transgender college students. It's half of the minority girls—Asian, Hispanic, Native American, Black—in a study of middle schoolers. And they don't all recover: eating disorders kill more people than any other mental health disorder.
• How Dangerous Are the Long-Term Effects of Anorexia? (EatingDisorderHope.org)
• Critical Points for Early Recognition and Medical Risk Management in the Care of Individuals with Eating Disorders (10 pages, free download from Academy for Eating Disorders (AED) .
• Videos about eating disorders (Academy for Eating Disorders)
• Anorexia (NY Times fact sheet)
• Anorexia, the Impossible Subject (Alice Gregory, New Yorker, 12-11-13) A review of How to Disappear Completely: On Modern Anorexia by Kelsey Osgood. "What sets Kelsey Osgood's memoir apart from the existing literature on anorexia is the author's commitment to stripping the glamour and romance from the illness. Yes, Osgood suffered from anorexia, but she refuses here to play the game of 'eating-disorders porn', focusing instead on how we must learn better ways to discuss anorexia in order to 'undermine its currency', to save ourselves and our loved ones from the nightmare that it is. Intelligent, moving, beautifully written, Osgood has written a paean to wellness, and taken a forthright look at everything that anorexia, 'bastard child of vanity and self-loathing', took from her life."--Molly McCloskey, author of "Circles Around the Sun."
• Eating disorder not otherwise specified (EDNOS), Wikipedia entry
• EDNOS: Most Dangerous, Unheard of Eating Disorder (Video, Nightline, ABC News, 11-14-12) At least 12 million people (mostly women) suffer the disdorder, which can be deadly. Two stories.
• Amy's story of Ednos: you don't have to be underweight or appear 'unhealthy' to be suffering (Mental Health Foundation, UK) Ednos consists of cycles of restricting food, then bingeing, followed by purging after feelings of shame and guilt. An obsessive nature and over awareness is common surrounding food, weight, and calorie control, where restricting and avoiding meals is another of the many symptoms.
• Something Fishy (website on eating disorders)
• Eating Disorders (free detailed booklet describes the symptoms, causes, and treatments of eating disorders, National Institutes of Mental Health)
• National Eating Disorder Information Centre's blog
• My name is Ron, and I am a food addict (Ron Cothran, CNN, 3-28-14 ) He writes that after gastric bypass surgery, "I no longer could eat to feel better; I needed to find a healthier way to deal with life." One reader comments: "You know what's worst of all? The treatment for chronic overeating is to think about every food choice you make for the rest of your life."
• A Small Loss (Mary W's blog about her struggle with weight loss-gain-loss).
• Eating disorders 'prevalent among fitness professionals' (Rhiannon Beacham, BBC News, 12-31-12)
• Gaining: The Truth About Life After Eating Disorders by Aimee Liu, whose memoir of life with anorexia, Solitaire, came out when she was 25.
• YMCA patrons stage intervention for anorexic woman (Steve Hartman, CBS News, 5-2-14)
• Wasted: A Memoir of Anorexia and Bulimia by Marya Hornbacher. Written at 23 for young adults, this brutally candid memoir may "trigger" those still in grips or early stages of disease, say some readers, serving as a how-to guide for eating disorders. Good insight for families of those with ED.
• Mirror, Mirror Off the Wall: How I Learned to Love My Body by Not Looking at It for a Year by Kjerstin Gruys
• Diabulimia: All in Our Heads? (Amy T, DiabetesMine, 10-28-10). In 2007, journalists began writing about diabulimia (women with type 1 diabetes, who were shunning their medication for fear of getting fat-- or restricting or stopping taking their insulin to lose weight). See articles by expert Ann Goebel-Fabbri, at the Joslin Diabetes Center. There is a new book by Maryjeanne Hunt about battling this eating disorder: Eating to Lose: Healing from a Life of Diabulimia, which is reviewed here.
• Binge Eating in Men: Understanding a Widely Misunderstood Eating Disorder (Carolyn C. Ross, Psychology Today, 10-2-12)
• Narrowing an Eating Disorder (Eating Disorder Not Otherwise Specified, or Ednos, by Abby Ellin (NYTimes, 1-18-10)
• Shattered Image: My Triumph Over Body Dysmorphic Disorder by Bryan Cuban
Dual diagnosis, or co-occurring disorders
• Addiction and Depression: Treating Co-Occurring Disorders (Peter Andrew Sacco, Everyday Health)
• Co-Occurring Disorders (SAMHSA, Substance Abuse and Mental Health Services Administration). The coexistence of both a mental health and a substance use disorder is referred to as co-occurring disorders.
• NAMI on Dual Diagnosis (National Alliance on Mental Illness)
• 25 research articles on the Hazelden Co-occurring Disorders Program (Behavioral Health Evolution)
• Co-Occurring Disorders (Psychology Today)
• Robin William's Suicide and Connection with Dual Diagnosis (Sarah A. Benton, Psychology Today, 8-18-14)
• Motivating Someone to Stop Substance Abuse (Harris B Stratyner, Psychology Today, 5-23-11)
• A Beginner's Guide to the Rx Drug Abuse Epidemic in America (Foundations Recovery Network) Part 4: The Mental Health Factor.
Christopher Solomon. The Boy Who Lived on Edges (Outside Online, 5-33-18) When extreme skier Adam Roberts was killed by an avalanche in the mountains of Washington State, some people wondered if he’d died on purpose. Solomon reconstructs a life in which athletic talent, fearlessness, and mental illness combined to create an unbearable reality. "To survive in such places, Adam no longer had the luxury of a noisy mind. All else had to fall away. For a few minutes the freight trains that banged through his head grew quiet. The silence was a form of freedom."
Narcissistic Personality Disorder
• Everything You Always Wanted to Know About Narcissism (Sander van der Linden, Psychology Today, 1-25-16)
• Will I Ever Be Good Enough?: Healing the Daughters of Narcissistic Mothers by Karyl McBride
• The Narcissism Epidemic: Living in the Age of Entitlement by Jean M. Twenge and W. Keith Campbell
• Hallmark of narcissistic disorder (also on BPD Central)
• Is there a narcissist in your life? (Temma Ehrenfeld, Psychologies, 8-28-14) .While we may all act narcissistically at times, people with a narcissistic personality disorder act this way all the time, with everyone else oblivious to the damage they inflict on those around them.
• Narcissistic Personality Disorder WebMD)
• Narcissism -- to a point -- can make more effective leader, researchers find (Science Daily, 1-15-14) When it comes to leadership, a moderate amount of narcissism can go a long way.
• Identifying and Understanding the Narcissistic Personality by Elsa F. Ronningstam
• The Handbook of Narcissism and Narcissistic Personality Disorder, edited by W. Keith Campbell and Joshua D. Miller
• Why Is It Always About You? : The Seven Deadly Sins of Narcissism by Sandy Hotchkiss
Obsessive-compulsive disorder (O.C.D.),
including hoarding behavior
• When your thoughts become fears and your fears become obsessions (Carlos Lozada, Washington Post, 1-25-15). "Linger for a moment on those irrational thoughts that sometimes hop the mind’s rope line. What would happen if I drove against traffic in the thick of rush hour? What if my completely healthy loved one died tomorrow?...Imagine now that the thoughts are not quickly cast out, but instead claim more and more space until they overwhelm everything else, all but the awareness that you can’t stop them. Trying to banish them only ensures their persistence. Some people develop distractions — compulsive, repetitive behaviors — to fight back. But the compulsions aggravate the obsessions. Being caught in this destructive loop is what it means to live with obsessive-compulsive disorder." A review of the book The Man Who Couldn't Stop: OCD and the True Story of a Life Lost in Thought and the story in brief of its author, David Adam. "The memoirist knew he didn't have AIDS, but he couldn't stop thinking about it."
• Can This Man Stop Lying? (Ellen Barry, NY Times, 11-29-22) Christopher Massimine, whose compulsive lying derailed a promising career in theater, maintains that it’s a mental illness that has dogged him since childhood. Links to more material, including Why Liars Tell Pointless Lies (Christian L. Hart, The Nature of Deception, Psychology Today, 9-26-22) A “small group of prolific liars,” as the researchers termed it, constituted around 5.3 percent of the population but told half the reported lies, an average of 15 per day. "Some were in professions, like retail or politics, that compelled them to lie. But others lied in a way that had no clear rationale."
• Patient Voices: O.C.D. (NY Times Health Guide, 9-24-09) Nagging doubts, compulsions, concerns of contamination, obsessive hoarding: the symptoms of obsessive-compulsive disorder are numerous and varied. What is it like to live this way? How does one maintain a normal life? Six men and women speak about their battles with this disorder. Join the discussion.
• Debunking the myths of OCD (Natascha M. Santos, Ted-Ed Original video lesson)
• Turtles All the Way Down by John Green ("It’s the most powerful and open book about mental illness that I have read, and it’s required reading for everyone, but especially those who don’t understand the intensity of OCD and extreme anxiety," writes Kate Olson on Amazon). See Green on his OCD on Sixty Minutes.
• Lyme disease linked to obsessive-compulsive symptoms (Chloe Reichel, Journalist's Resource, 5-8-18) Lyme disease, a bacterial infection spread through ticks, has been linked in a study to a new concern: obsessive-compulsive symptoms (OCS). Reichel explains the findings and two possible explanations for the findings.
• Being Me with OCD: How I Learned to Obsess Less and Live My Life by Alison Dotson (part memoir, part self-help for teens--and a guide for friends and family members)
• "It'll be Okay.": How I Kept Obsessive-Compulsive Disorder (OCD) from Ruining My Life by Shannon Shy
• Triggered: A Memoir of Obsessive-Compulsive Disorder by Fletcher Wortmann. (Listen to interview on Talk of the Nation (NPR, 3-29-12)
• An Obsessive Compulsive's 'Life In Rewind' (Talk of the Nation story about Ed Zine, whom it took 16,384 precise movements to get from his bed to the bathroom). Read the compelling book: Life in Rewind: The Story of a Young Courageous Man Who Persevered Over OCD and the Harvard Doctor Who Broke All the Rules to Help Him by Terry Weible Murphy, Michael A. Jenike, M.D., and Edward Zine.
• The OCD Diaries (Bill Brenner's blog, this entry: The Love Story Continues--Happy Birthday, Erin!)
• The Infamous Rikers Inmate Who Stole Entire Subway Trains (John Surico, Vice, 6-8-16) Darius McCollum is something out of New York City tabloid lore: the guy who gets caught over and over again (30 times, in total), impersonating a subway conductor or bus driver; stealing said vehicle; and then, eventually, getting caught. has been diagnosed with Asperger's Syndrome, with an obsession he can't seem to shake, but there's more to it than that--OCD, the impulse control. And jails don't try to deal with the psychology at the base of the repeated behavioral problem.
• Interview with Dr. Jeffrey Schwartz, expert on OCD, on how much choice and control we actually have (by refocusing our attention) over things like mood, addictions, and overeating (on YouTube). Schwartz is the co-author of You Are Not Your Brain: The 4-Step Solution for Changing Bad Habits, Ending Unhealthy Thinking, and Taking Control of Your Life. He says that 2% of the population has OCD, but most people hide it. His earlier book is Brain Lock: Free Yourself from Obsessive-Compulsive Behavior. Leonardo DiCaprio does an excellent job portraying Howard Hughes' OCD in the film The Aviator; it also took him three months to stop OCD behaviors, after finishing the movie.'
• The Mindfulness Workbook for OCD: A Guide to Overcoming Obsessions and Compulsions Using Mindfulness and Cognitive Behavioral Therapy by Jon Hershfield and Tom Corboy
• The Different Types of Obsessive-Compulsive Disorder (OCD-UK) Explains (and breaks down further) the four main types of OCD (1. checking, 2. contamination/mental contamination, 3. hoarding, and 4. ruminations/intrusive thoughts) and some of the fears associated with them.
• K for OCD: The pros and cons of ketamine (Tracie White, Stanford Medicine, Summer 2017 issue) While ketamine is approved by the U.S. Food and Drug Administration as an anesthetic, it is also an illicit party drug known as “Special K,” with hallucinogenic effects and the potential for abuse. Ketamine has brought hope to a psychiatric field desperate to find new treatments for severe OCD, a chronic condition marked by debilitating obsessions and repetitive behaviors. Current treatments, which include antidepressants such as Prozac, can take months to have any effect on the disease, if they work at all. Severe OCD takes such a toll on patients,” says Carolyn Rodriguez, MD, PhD, who as a researcher at Columbia University ran the OCD trial. In 2013, Rodriguez and colleagues published their results from that first clinical trial of ketamine in OCD patients. The trial randomized 15 patients with OCD to ketamine or placebo. In those patients who were given ketamine, the effect was immediate. Patients reported dramatic decreases in their obsessive-compulsive symptoms midway through the 40-minute infusion, according to the study. The diminished symptoms lasted throughout the following week in half of the patients...Ultimately, Rodriguez says, she hopes the study will lead to the discovery of other fast-acting drugs that work in the brain like ketamine but without its addictive potential.
• Compulsion (Candace Mittel Kahn, Shannon Cason, The Trouble, WBEZ, 3-14-18) Jamie has always been painfully shy, she’s always had severe anxiety, and she’s also always suffered from obsessive-compulsive disorder. But it was all manageable. She could “keep up with it,” she says. Until 2017, when everything got worse. A lot worse. And as the year progressed, Jamie began to question her grip on reality as OCD slowly started to take over her life.
• Compulsive hoarding (OC Foundation)
--Hoarding: How Much Stuff is Too Much? (Mary Mihaly, Healthy Outlook blog, 1-4-12)
--Shop 'Til You Stop: How to Treat Compulsive Spending Melinda Beck, Health Journal, WSJ, 12-6-11)
• Buried by His Past (Corey Kilgannon, NY Times, 3-7-14) "A Son of Privilege, Consumed by Hoarding, Faces a Deadline to Pack Up and Move Out" The younger son of Tex McCrary and Jinx Falkenburg, he appeared on an episode of the A&E TV show “Hoarders.” "A large team of workers removed eight truckloads from the apartment, creating trench-like walkways, but they really only put a dent in the collection. Mr. McCrary’s insistence upon managing the removal of items wound up slowing, and ultimately halting, the operation."
• Hoarding disorder: why I'm examining it in my latest book (Maggie James, who writes about three novels that feature hoarding behavior) "Common items to hoard include newspapers and magazines, books, clothes, letters (including junk mail), containers such as cardboard boxes, and household supplies." (Gulp)
Post-traumatic stress disorder (PTSD)
The degree of PTSD may vary, but it's hard to escape military service without it.
• Post-Traumatic Stress Disorder (PTSD) (SAMHSA) Substance Abuse and Mental Health Services Administration.
NEED HELP?
If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org
To learn how to get support for mental health, drug, and alcohol issues, visit FindSupport.gov.
To locate treatment facilities or providers, visit FindTreatment.gov or call SAMHSA’s National Helpline at 800-662-HELP (4357).
• The Many Forms, Faces and Causes of PTSD (James Doubek, Eric McDaniel, and Ed McNulty, National Public Radio, 11-19-17) "Post-traumatic stress disorder is often associated with combat, but trauma comes in many forms... "About 7 or 8 percent of people experience PTSD at some point in their lives, according to the Department of Veterans Affairs. The rate is higher for women than for men: about 10 percent compared with 4 percent. Experiencing sexual assault or child sexual abuse, or living through accidents, disaster or witnessing death can all be contributing factors, in addition to time in combat with the military. Symptoms include: Re-experiencing traumatic events; feeling both jumpy and withdrawn at the same time; avoiding reminders of his "time around the traumatic event." "We know now that the lifetime experience before the trauma, the nature of the trauma itself, and what happens to you after the trauma — even though unrelated to trauma — all matter for whether you are going to get PTSD," he explains.
• Posttraumatic stress disorder and the nature of trauma (Bessel van der Kolk, MD, Dialogues Clin Neurosci, PubMed, March 2000) "The role of psychological trauma (eg, rape, physical assaults, torture, motor vehicle accidents) as an etiological factor in mental disorders, anticipated as early as the 19th century by Janet, Freud, and Breuer, and more specifically during World War I and II by Kardiner, was “rediscovered” some 20 years ago in the wake of the psychological traumas inflicted by the Vietnam war and the discussion “in the open ” of sexual abuse and rape by the women's liberation movement. 1980 marked a major turning point, with the incorporation of the diagnostic construct of posttraumatic stress disorder (PTSD) into the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) and the definition of its main diagnostic criteria (reexperiencing of the traumatic event, avoidance of stimuli associated with the trauma, and symptoms of increased arousal). Initially described as resulting from a onetime severe traumatic incident, PTSD has now been shown to be triggered by chronic multiple traumas as well."
• The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk. “The Body Keeps the Score articulates new and better therapies for toxic stress based on a deep understanding of the effects of trauma on brain development and attachment systems. This volume provides a moving summary of what is currently known about the effects of trauma on individuals and societies, and introduces the healing potential of both age-old and novel approaches to help traumatized children and adults fully engage in the present.”~Jessica Stern, author of Denial: A Memoir of Terror/
• 'What My Bones Know' is Stephanie Foo's memoir on living with complex PTSD Sarah McCammon speaks with author and journalist Stephanie Foo (NPR, 2-27-22) about her new book, What My Bones Know: A Memoir of Healing from Complex Trauma
• How PTSD Became a Problem Far Beyond the Battlefield (Sebastian Junger, Vanity Fair, 5-7-15) Though only 10 percent of American forces see combat, the U.S. military now has the highest rate of post-traumatic stress disorder in its history....Because PTSD is a natural response to danger, it’s almost unavoidable in the short term and mostly self-correcting in the long term. Only about 20 percent of people exposed to trauma react with long-term (chronic) PTSD.... 'The problem doesn't seem to be trauma on the battlefield so much as re-entry into society.' People in military service are surrounded by close comradeship. When they are thrust back into American society they are often isolated. The problem is with our lack of community back home."
• Not Just For Soldiers: Civilians With PTSD Struggle to Find Effective Therapy (Caroline Covington, Shots, NPR, 5-20-19) "PTSD has long been associated with members of the military who have gone through combat, and with first responders who may face trauma in their work. It's also associated with survivors of sexual assault, car accidents and natural disasters. But researchers have also learned it can develop in adults who have experienced chronic childhood trauma — from physical, emotional or sexual abuse by caregivers or from neglect or other violations of safety."
• PTSD Self Test (Safe Harbor House) The PTSD Checklist for DSM-5, frequently referred to as the PCL-5, is a self-assessment to measure the presence and severity of PTSD symptoms.
• FAQs about PTSD (JFlowers)
• PTSD. National Center for PTSD (informative U.S. Dept of Veterans Affairs website--click on "Search PILOTS" to find published articles on various aspects of post-traumatic stress disorder). Download free: Psychological First Aid: Field Operations Guide(an evidence-informed modular approach for helping people immediately after a disaster or terrorism).
• FAQs about PTSD (JFlowers)
• Get help with Posttraumatic Stress Disorder (PTSD) (American Psychiatric Association). Helpful links.
• When the future is running out, narrating the past helps to prepare (Dhruv Khullar, Washington Post, 7-14-19) "Humans are natural storytellers. We have tremendous power to frame a narrative. The same series of events... can be a tale of resilience and restoration or misfortune and regret. The process of bringing coherence to one’s life story is what psychologist Dan McAdams calls creating a 'narrative identity'....In a 2018 study, researchers assigned veterans with post-traumatic stress disorder to engage in either five 30-minute writing sessions in which they reflected on traumatic experiences, or a rigorous 12-week program of cognitive processing therapy (CPT), a first-line treatment for PTSD. The study found that the short writing sessions were just as effective at reducing PTSD symptoms as the resource-intensive CPT program.
• 21 Ways to Help Someone with PTSD Handle a Triggering Appointment (Heidi Hanson, New Synapse) "Because my traumas were medical in nature, it has been challenging for me to handle any appointment with a doctor or dentist." Hanson's site is full of advice on how to handle triggering events, and how to help people with PTSD handle such events.
• Five First Responders to the Pulse Massacre. One Diagnosis: PTSD. (Abe Aboraya, WMFE and Pro Publica, 6-11-18) Men threw away their uniforms, they were covered in so much blood. And then the nightmares started. “My head’s still not right,” said one paramedic who responded to the Pulse nightclub shooting two years ago. He and some other responders say their departments haven’t given them the help they need. "Finally, in August, McLay told Granada that he had been told that a top Fire Department official had said, 'PTSD is bullshit. These pussies need to man up,' Granada said."
• Understanding PTSD (excellent infographic, Jenna Baskin, DisabledVets.com)
• First Responders in Florida Aren't Covered for PTSD. That May Change After Parkland. (Abe Aboraya, WMFE and Pro Publica, Local Reporting Network, 3-1-18) Like many states, Florida does not provide lost wages to first responders disabled with PTSD. A bill that would change that is now gaining momentum after 17 people were killed at Marjory Stoneman Douglas High School.
• Help Us Investigate PTSD in First Responders (Abe Aboraya, WMFE, and Beena Raghavendran, ProPublica, 3-1-18) ProPublica is teaming up with Orlando public radio station WMFE to examine the toll PTSD has taken on first responders and their relatives. Tell us your story.
• Return to Ward 17: Making peace with lost comrades (Dean Yates, Reuters Investigates, 4-18-18) "During my first hospitalisation in Ward 17 in 2016, I learned how I’d developed post-traumatic stress disorder (PTSD) from years of covering war, terrorist attacks and natural disasters in the Middle East and Southeast Asia for Reuters....But I did not make peace with the event that really drove me into mental hell. I was only starting to comprehend the moral dimension of losing Namir and Saeed," two Iraqis, "for what I saw as my complicity in their deaths."
• Prison Employees Face Same Rates of PTSD as War Veterans, New Research Claims (Scottie Andrew, Newsweek, 7-13-18) "Up to 20 percent of recent war veterans suffer post-traumatic stress disorder from their experiences, according to the Department of Veterans Affairs. A new study claims prison work can disrupt mental health in the same way.... Prison work is harrowing, researchers said, and employees face some of the 'toughest working conditions of U.S. workers,' lead author Lois James said in a statement. Staff surveyed constantly feared for their safety at work, and almost half of them witnessed a co-worker’s beating at an inmate’s hands....Mental illness among the incarcerated is exceptionally high in the United States...Called America’s 'warehouses for the mentally ill,' prisons and jails hold 10 times more mentally ill people than state psychiatric hospitals."
• Virtual Reality: Expanding Use in Mental Health Treatment (American Psychiatric Association, 2-9-17)
• In 'The Evil Hours,' A Journalist Shares His Struggle With PTSD (Dave Davies interviews David Morris on Fresh Air, NPR, 1-20-15). While embedded with troops in Iraq, David Morris almost died when a Humvee he was riding in ran over a roadside bomb. His book, The Evil Hours: A Biography of Post-Traumatic Stress Disorder, explores the history and science of post-traumatic stress disorder.
• The Fighter (C. J. Chivers, NY Times Magazine, 12-28-16). The Marine Corps taught Sam Siatta how to shoot. The war in Afghanistan taught him how to kill. Nobody taught him how to come home. The Pulitzer Committee gave this a Pulitzer award "For showing, through an artful accumulation of fact and detail, that a Marine’s postwar descent into violence reflected neither the actions of a simple criminal nor a stereotypical case of PTSD."
• Nurses Say Stress Interferes With Caring For Their Patients (Alan Ty, Shots, NPR, 4-15-16) A registered nurse at the emergency department at St. Francis Hospital in Hartford, Conn., describes her workplace as phones going off, voices everywhere, every room full. "You look around and the hallways are full of patients on stretchers; you walk out to the waiting room and you can see on our board that there's 15 people signing in," she says. "The second you can get your ICU patient upstairs, there's another one waiting for you."She typically doesn't get a chance to eat or drink or go to the bathroom during her 12-hour shiftNursing has long been considered one of the most stressful professions. According to a 2007 study, 24 percent of ICU nurses and 14 percent of general nurses tested positive for symptoms of post-traumatic stress disorder.
• A Marine Attacked an Iraqi Restaurant. But Was It a Hate Crime or PTSD? (Dave Philipps, NY Times, 10-18-17) After a Marine attacked an Iraqi restaurant in Portland, Ore., his family said he was provoked by trauma, not hate, and that he needed help, not jail time.
• How Hunting Invasive Species in the Everglades Is Helping Veterans Cope with PTSD (Maria Bakkalapulo, Here and Now, NPR, 12-20-17) A group of veterans who call themselves "The Swamp Apes" have found that hunting the invasive Burmese python can help the environment, while also treating their combat-induced post-traumatic stress disorder.
• Thirty Years Ago I Watched My Friend’s Father Drown. I Think About It Every Time My Children Go Near Water. (Christie Tate, Narratively, 9-2-16, originally on Motherwell) How can I let my kids enjoy the waterpark, pool or beach, when just a few seconds of fun floods my brain with PTSD?
• Parenting with PTSD (resources list)
• A True Story of Veterans Who Came Home and Found New Ways to Serve (Diane Rehm show, 11-11-15, with guest Joe Klein, author of Charlie Mike: A True Story of Heroes Who Brought Their Mission Home, and veterans Ken Harbaugh and Mike Pereira. When former Army sergeant Mike Pereira came home from Iraq, things fell apart quickly. He had panic attacks, his girlfriend left, and he spent his days in a fog. The friendship of another veteran helped him start to address his PTSD, but when that friend took his own life, Pereira was lost. What finally brought him relief was serving again – this time in his community. For many veterans, putting their military skills to use in public service projects can be healing during the transition to civilian life. Journalist and author Joe Klein writes their stories in a new book – and says it’s time to recognize the huge potential in our returning military ranks. The stories behind one positive path for returning veterans. Listen or read transcript.
• PTSD (Posttraumatic Stress Disorder): Combat: Winning the War Within (Ilona Meagher’s blog)
• Veterans Groups Push for Medical Marijuana to Treat PTSD (Reggie Ugwu, NY Times, 11-3-17) For more than a year, a diverse and bipartisan group that includes criminal justice reform advocates, Big Alcohol, and veterans groups has been working to reframe the debate about the federal prohibition of marijuana as a question of not only moral and economic imperatives, but also patriotic ones, arguing that access to medical marijuana could ease suffering and reduce suicide rates among soldiers who return from the horrors of war. “We’ve got young men and women with PTSD and traumatic brain injuries coming to us and saying that cannabis works,” says a spokesman for the American Legion. '[Mr. Plenzler said that veterans had turned to medical marijuana as an alternative to so-called “zombie drugs,” including opioids and antidepressants, that they said adversely affected their mood and personality, up to and including thoughts of suicide.' The American Legion "asked Congress to remove the drug from the list of Schedule 1 narcotics — a class that includes heroin, LSD and other drugs that have “no accepted medical use” and a high potential for abuse — and reclassify it in a lower schedule. It also called on the Drug Enforcement Administration to license more privately funded growers to focus on medical research."
• Agony over ecstasy: FDA bid shows it’s hard to test psychedelics (David Ovalle and Daniel Gilbert, Health, Washington Post, 4-27-24) An independent analysis of clinical studies of MDMA-assisted therapy raised doubts about the results. The first attempt to win government approval of a psychedelic drug for mental health treatment is generating skepticism about its clinical trials, a case that reveals the unique challenges of bringing mind-altering, illegal drugs into mainstream medical care. A recent independent analysis questioned the integrity of patient studies that are being used to support the Food and Drug Administration application for MDMA — also known under the street name ecstasy — to treat post-traumatic stress disorder, citing a host of problems.
• The Washington Post: Ecstasy Could Be ‘Breakthrough’ Therapy For Soldiers, Others Suffering From PTSD (William Wan, WashPost, 8-26-17) For Jon Lubecky, the scars on his wrists are a reminder of the years he spent in mental purgatory. He returned from an Army deployment in Iraq a broken man. He heard mortar shells and helicopters where there were none. He couldn’t sleep and drank until he passed out. He got every treatment offered by Veterans Affairs for post-traumatic stress disorder. But they didn’t stop him from trying to kill himself — five times.
• What Does a Parrot Know About PTSD? (Charles Siebert, NY Times Magazine, 1-28-16) An unexpected bond between damaged birds and traumatized veterans could reveal surprising insights into animal intelligence. "In an extraordinary example of symbiosis, two entirely different outcasts of human aggression — war and entrapment — are somehow helping each other to find their way again."
Wounded Warriors: A Soldier's Story of Healing through Birds by Robert C. Vallieres and Jacquelyn M. Howard. (Robert C. Vallieres struggled to find his “new normal” when he returned home after serving in the military. An accident in Kuwait left him suffering from traumatic brain injury (TBI) and internal injuries, leaving him in constant pain. Wounded Warriors is Vallieres’s story of self-healing from crippling “invisible” wounds through the help of birds. The problems of TBI and post-traumatic stress disorder do not have definitive solutions. His story of recovery offers a winged hope to thousands of military personnel who suffer these physical and mental battles.
• How Service and Therapy Dogs are Helping PTSD Victims (Kristina Kledzik, Daily Treat, a blog by Rover.com)
• Gift from Within: PTSD Resources for Survivors and Caregivers. This site is packed with articles on various practical ways to understand and deal with PTSD. Thanks to Jennifer McGregor for recommending this and several other helpful articles listed here.
• Over a Quarter-Million Vietnam War Veterans Still Have PTSD (Brian Handwerk, Smithsonian, 7-22-15) Forty years after the war's end, twice as many vets with combat-related PTSD are getting worse as those who are improving.
• Asking for help is strength, not weakness (Wounded Warrior Project)
• PTSD in the Workplace: What Employers and Coworkers Need to Know (Amy Menna, Gift from Within)
• The Stages of PTSD Recovery (PTSD Treatment Health, 855-315-3815, confidential helpline)
• Traumatic Stress in Women Veterans (PTSD: National Center for PTSD, U.S. Dept. of Veterans Affairs)
• PTSD Symptoms Put Women at Greater Risk for Type 2 Diabetes (Liz Seegert, HealthLine, 1-7-15)
• A Brain on Fire (Amy Li, Crime and Punishment, Narratively, 1-22-18). A brain on fire does not belong to a human being. The controls are handed over to the animal machine. The base instinct, the lizard brain. Fight or flight. I always fight. It doesn’t feel like a choice. It doesn’t feel like something I want to do. It feels like something I have to do, no matter how much I don’t want to. "I finally realized how to stop turning my grief into anger. But not before I threw a woman through a window."
• No End to Trauma for Some Older Veterans (Paula Span, The New Old Age, NY Times, 3-15-13). “But at least now they know about this stuff. Nobody told me anything for 55 years.”
• Addiction and Suicide Amongst Veterans: Finding Hope In The Darkness (DrugRehab.org). This article contains practical advice about dealing with PTSD. "PTSD is one of the primary reasons veterans may turn to drugs or alcohol – as a coping mechanism to deal with the traumatic memories, feelings of depression, and anxiety resulting from PTSD – particularly if the disorder is inadequately treated or, in the worst-case scenario, undiagnosed or untreated at all." You can also download a family guide.
• Home Management Strategies for PTSD(for parents, about children -- on AnxietyBC)
• The Lingering Trauma of Child Abuse (Susanne Babbel, Psychology Today, 4-23-11). In part the author talks about how in some cases child abuse can develop into PTSD later in life.
• Post-Traumatic Stress Disorder For Dummies by Mark Goulston. Help your heart accept what your mind already knows.
• A Physician’s Take on PTSD (Adam Wahlberg, Think Piece, interviews physician Ron Glasser on how soldiers today survive the impact of PTSD and struggle to readjust to society). Here's an earlier Think Piece interview with Glasser, whose book 365 Days documented his time as a physician during the Vietnam war and explained why Mailer's novel The Naked and the Dead is overrated.
• PTSD. William Finnegan,The Last War: A decorated marine's war within (New Yorker, 9-29-08)
• PTSD. Virtual Iraq: Using simulation to treat a new generation of traumatized veterans (Sue Halpern, New Yorker, 5-19-08)
• PTSD Information Center (U.S. Dept of Veterans Affairs answers to questions about posttraumatic stress disorder)
• The Post-Traumatic Stress Disorder Sourcebook: A Guide to Healing, Recovery, and Growth by Glenn Schiraldi
• How Trauma Can Help You Grow (Kristine Crane, U.S. News, 9-8-14) A 'profound awakening' – is not unusual among survivors of traumatic events. The phenomenon is called “post-traumatic growth” and it’s at the opposite end of the spectrum from post-traumatic stress syndrome, which almost always precedes it, says Melinda Moore."
• Heal My PTSD (blog by Michele Rosenthal, author of the memoir Before the World Intruded: Conquering the Past and Creating the Future
• Post Trauma Stress Disorder-Suggestions for Survival (PTSDSupport.net)
• How Does Post-Traumatic Stress Disorder Change the Brain? ( Viatcheslav Wlassoff, PhD, BrainBlogger, 1-24-15) PTSD stifles the life force out of its victims. It is no use telling them to “get over” it because PTSD fundamentally changes the brain’s structure and alters its functionalities.
• In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness by Peter A. Levine
• The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment by Babette Rothschild
• Healing Combat Trauma (Lily Casura's blog, therapeutic resources for combat=based PTSD, focused on integrative medicine and hope).
• Top 50 bloggers shed light on PTSD (Masters in Psychology, with helpful descriptions of each blog's focus)
• 40 Excellent Blogs for PTSD Support (Nursing Schools, 2010)
• Top 25 PTSC Blogs (Medical Assistants Schools, 2010)
• Navy SEAL Loses Battle with PTSD (Here and Now, WBUR, 1-14-13). For a Navy Seal, getting help for PTSD disqualifies you for security clearance, and in this case, Rob Guzzo, who served in Iraq, went for help too late. "For a SEAL, if you don’t have a security clearance, you don’t go on secret classified missions, therefore you’re not a Navy SEAL.”
Schizophrenia
• What Is Schizophrenia (National Institute of Mental Health, NIMH)
• Schizophrenia (American Psychiatric Association, APA)
• Mental Illnesses, see specific types (National Alliance on Mental Illness, NAMI). NAMI is an important and influential patient advocacy group--providing support for patients and families and serving as a watchdog in a field that is still in relatively exploratory stages of learning how to diagnose and treat and distinguish between various forms of mental illness.
• Suspect Molecules Overlap in Autism, Schizophrenia, Bipolar Disorder (Science Update, NIMH, 3-1-18) Shared patterns of gene expression may hold clues to disease processes.
• Scientists Move Closer to Understanding Schizophrenia’s Cause (Benedict Carey, NY Times, 1-27-16) That risk, they found, is tied to a natural process called synaptic pruning, in which the brain sheds weak or redundant connections between neurons as it matures. During adolescence and early adulthood, this activity takes place primarily in the section of the brain where thinking and planning skills are centered, known as the prefrontal cortex. People who carry genes that accelerate or intensify that pruning are at higher risk of developing schizophrenia than those who do not, the new study suggests.
• Committed: A Memoir of Madness in the Family by Paolina Milana. The unexpected death of her father soon after she returns home leaves Paolina in shock―and in charge of her paranoid schizophrenic mother. But it isn’t until she is twenty-seven and her sister two years her junior explodes in a psychotic episode and, just like Mamma, is diagnosed with paranoid schizophrenia and must be committed, that Paolina descends into her own despair, nearly losing herself to the darkness.
• I’m a Neuroscientist Who Studies Mental Illness. Here’s What Happened When I Lost My Own Mind. (Barbara K. Lipska, Washingtonian, 4-8-18) Lipska, an expert in schizophrenia, director of the Human Brain Collection Core at NIH’s National Institute of Mental Health, never knew that cancer and its complications could cause the same symptoms as the disease she studied—until she was diagnosed with melanoma. "I've studied mental illness my entire career. Yet when I began my descent into the very same sort of madness that I'd researched, I had no idea what was happening. This is the story of my journey into insanity—and back." Excerpted from the book
The Neuroscientist Who Lost Her Mind: My Tale of Madness and Recovery (Lipska with Elaine McArdle)
• What schizophrenia does to families — and why the mental health system can’t keep up (Abigail Jones, Washington Post magazine, 1-19-2020) A mother, a son, an unraveling mind — and a mental health system that can’t keep up. "Over the past 20 years, Aaron has spiraled from a high school star and an academic all-American on the Arizona State University football team to a ward of the state of Maryland. He has been captive not just to a schizophrenic brain but to a perfect storm of factors — underfunded treatment facilities, prisons and jails serving as de facto asylums, a lack of advancements in medication — that has made it generally harder for people with serious mental illnesses to get the help they need."
• Schizophrenia Finds Its Virgil (Thomas Levenson, Download the Universe), a review of Speaking to My Madness: How I Searched for Myself in Schizophrenia by Roberta Payne ("a memoir of distinctly literary quality").
• Patient Voices: Schizophrenia (NY Times Health Guides) Characterized by paranoia, anxiety, hallucinations and delusions, schizophrenia and schizoaffective disorder, a related condition, are complicated mental illnesses that make it difficult for one to determine the difference between reality and pretend. While there are medications and therapies that can help, the effects of this condition are often far- reaching. Here, seven men and women speak about living with schizophrenia or schizoaffective disorder. Join the discussion.
• Is There No Place on Earth for Me? by Susan Sheehan (foreword by Robert Coles). "Sheehan is tenacious, observant and unsentimental. The history of a single patient leads us into a maze of understaffed institutions, bureaucratic fumbling, trial-and-error treatment and familial incomprehension. Though Sheehan keeps herself invisible, her sympathy is palpable."~Walter Clemons, Newsweek. "A brilliantly documented chronicle of a young woman's long struggle with schizophrenia." —The New Republic
• The Voices in My Brother's Head (Maria Lazzati, Narratively, 9-24-13) After schizophrenia upended a young man’s life, the notes he left behind offer clues to the horrors that haunted his mind.
• Good Looks Ran in the Family. So Did Schizophrenia. (Sam Dolnick, NY Times, 4-3-2020) A review of Hidden Valley Road: Inside the Mind of an American Family by Robert Kolker. '“Hidden Valley Road” tells the terrifying story of a family swallowed whole by schizophrenia, a disease that no one understood, not doctors or researchers, and certainly not the Galvins....The story of the geneticists’ quest to understand the disease comes as a relief to the family’s anguish. And one researcher, Lynn DeLisi, whom we meet as a young mother in a decidedly male field, emerges as something of a hero....Years ahead of her time, DeLisi is convinced that schizophrenia is largely a genetic disease and through force of will, she seeks to make the case....More promising developments emerge in early detection, and in “soft intervention” techniques that combine therapy, family support and minimal medication....“For a family, schizophrenia is, primarily, a felt experience, as if the foundation of the family is permanently tilted in the direction of the sick family member,” Kolker writes.
• For Decades, Shame Kept My Dad’s Schizophrenia Secret from our Pakistani Immigrant Community (Shaheen Pasha, Narratively, 8-10-17) Now my concern for the mental health of my children is making me finally face my family’s past.
• Schizophrenia Runs in My Family. What Does That Mean for Me and My Baby? (Rheana Murray, NY Times, 8-1-19) The writer spent her mid-20s anticipating a psychotic break that never came. Soon to be a mother herself, she reflects on fear, family history and the future.
• “Recovery means being able to manage my illness to the point that you don’t know I’m schizophrenic unless I tell you.”— from the NAMI report card on the states (you can click on Full Report to get full PDF file)
• Why I’m Grateful to Care for My Brother Living With Schizophrenia (Corinne K., The Mighty, 10-10-19) It’s important to be grateful for the opportunity to take care of someone who needs help.
• Psycom has information about various forms of mental illness. What looks useful (on this particular topic) is the information it provides about various drugs to treat schizophrenia. I assume similar information is available for other forms of illness.
• A Tale of Mental Illness from the Inside (Elyn Saks, TEDGlobal 2012) Video with captions and transcript. "Is it okay if I totally trash your office?" It's a question Elyn Saks once asked her doctor, and it wasn't a joke. A legal scholar, in 2007 Saks came forward with her own story of schizophrenia, controlled by drugs and therapy but ever-present. In this powerful talk, she asks us to see people with mental illness clearly, honestly and compassionately.
• The Fortunate Mother: Caring for a son with schizophrenia (Rick Hampson, USA TODAY) The lucky one: Despite hardships, a mother knows it could be worse. For the mentally ill, relatives are the last to leave.
• Early intervention could change nature of schizophrenia (Liz Szabo, USA Today) Programs aim to prevent psychosis or halt a patient's decline.
• The Touch of Madness (David Dobbs, Pacific Standard, 10-3-17) Culture profoundly shapes our ideas about mental illness, which is something psychologist Nev Jones knows all too well. Jones had memory lapses, hallucinations, and trouble concentrating when she was still a promising doctoral candidate in philosophy. Too much space was opening within and around and below her. She worried she was going mad. She was diagnosed with schizophrenia. The way her schizophrenia was treated led her to realize that the way modern Western culture ostracizes the mentally ill only makes their condition worse. She switched fields from philosophy to psychology, and now lectures on the way culture can shape the trajectory of mental illness. "Nev has a way of saying things," says Cherise Rosen, a leader in first-episode psychosis response who collaborates with Jones and often sees her speak, "that gets people to see psychosis and schizophrenia in a new way. I've seen her pose questions that just stop a room for a moment—and then everyone is working around a new idea." "Jones stands out because she so effectively represents two things. First, she conveys, as few do, the fullness and urgency of the intellectual and evidence-based arguments for change. And second, she makes uniquely vivid the human stakes involved, both in the destruction of people's lives—to say nothing of their suffering—and in what the rest of us lose when culture casts them aside. For it happens that Jones herself was once deemed unreachable and flung into her own pit of despair. She re-emerged only because she found a therapist who listened, and a few strands of culture she wove into a lifeline."
• First Digital Pill Approved to Worries About Biomedical ‘Big Brother’ (Pam Belluck, NY Times, 11-13-17) 'For the first time, the Food and Drug Administration has approved a digital pill — a medication embedded with a sensor that can tell doctors whether, and when, patients take their medicine....Experts estimate that so-called nonadherence or noncompliance to medication costs about $100 billion a year, much of it because patients get sicker and need additional treatment or hospitalization. “When patients don’t adhere to lifestyle or medications that are prescribed for them, there are really substantive consequences that are bad for the patient and very costly,” said Dr. William Shrank, chief medical officer of the health plan division at the University of Pittsburgh Medical Center....Patients who agree to take the digital medication, a version of the antipsychotic Abilify, can sign consent forms allowing their doctors and up to four other people, including family members, to receive electronic data showing the date and time pills are ingested. A smartphone app will let them block recipients anytime they change their mind. Although voluntary, the technology is still likely to prompt questions about privacy and whether patients might feel pressure to take medication in a form their doctors can monitor. Dr. Peter Kramer, a psychiatrist and the author of “Listening to Prozac,” raised concerns about “packaging a medication with a tattletale.”' Emphasis added.
• Mental Illness in Academe. Elyn R. Saks on the day an incident of paranoid schizophrenia came on while she was teaching a class--and when and whether to "come out" about your mental illness (Chronicle of Higher Education, 11-25-09). Read her fascinating memoir, The Center Cannot Hold: My Journey Through Madness
• Understanding schizophrenia (Medically Speaking podcast with Anthony Lehman, chair of the department of psychiatry at the University of Maryland School of Medicine), 13 minutes
• Visualizing Schizophrenia (Irene Wielawski, NY Times, interviews Paul Thompson on visualizing progressive brain damage in people with schizophrenia)
• A mother helps son in his struggle with schizophrenia ( Stephanie McCrummen, Washington Post, 5-25-13)
• A Grieving Family Wonders: What if They Had Known the Medical History of Sperm Donor 1558? (Amy Dockser Marcus, Wall Street Journal, 1-2-22) Steven Gunner battled mental illness before a fatal overdose. It turns out his biological father had his own psychiatric problems. Some sperm banks test prospective donors to see if they carry genes associated with rare hereditary diseases like cystic fibrosis and Tay-Sachs disease. But there is no easy way to identify people at risk for schizophrenia, which is believed to affect about 1% of the population.
• A Brilliant Madness (Film, available on PBS, American Experience) A Brilliant Madness is the story of a mathematical genius whose career was cut short by a descent into madness. At the age of 30, John Nash, a stunningly original and famously eccentric MIT mathematician, suddenly began claiming that aliens were communicating with him and that he was a special messenger. Diagnosed with paranoid schizophrenia, Nash spent the next three decades in and out of mental hospitals, all but forgotten. During that time, a proof he had written at the age of 20 became a foundation of modern economic theory. In 1994, as Nash began to show signs of emerging from his delusions, he was awarded a Nobel Prize in Economics. The program features interviews with John Nash, his wife Alicia, his friends and colleagues, and experts in game theory and mental illness. You can also read the transcript. See Further Reading for leads to more good books on the subject.
• The Man Who Wasn't There: Investigations into the Strange New Science of the Self. Anil Ananthaswamy writes about what happens when our sense of self is compromised, how our how our body feels, for example, when our narrative, autobiographic self is damaged. He writes about conditions such as Alzheimer’s, schizophrenia, and ecstatic epilepsy from this perspective. Fascinating.
• The Quiet Room: A Journey Out of the Torment of Madness by Lori Schiller with Amanda Bennett. At seventeen Lori Schiller was the perfect child -- the only daughter of an affluent, close-knit family. Six years later she made her first suicide attempt, then wandered the streets of New York City dressed in ragged clothes, tormenting voices crying out in her mind. Lori Schiller had entered the horrifying world of full-blown schizophrenia. She began an ordeal of hospitalizations, halfway houses, relapses, more suicide attempts, and constant, withering despair. But against all odds, she survived.
• Electroconvulsive Therapy Program: A Brief History of ECT (Dept. of Psychiatry, University of Michigan Health System)
• Shulamith Firestone. Death of a Revolutionary (Susan Faludi, The New Yorker, 4-15-13). Feminist Shulamith Firestone helped to create a new society. But she couldn’t live in it. "In 2005, when Jean-Paul Selten and Elizabeth Cantor-Graae, experts on the epidemiology of schizophrenia, reviewed various risk factors—foremost among them migration, racism, and urban upbringing—they found that the factors all involved chronic isolation and loneliness, a condition that they called 'social defeat.' They theorized that 'social support protects against the development of schizophrenia.'" Society, and her feminist sisters, failed to provide that support for this pioneering feminist. A sad and important story.
Substance abuse and recovery
including approaches to treating alcoholism and addiction to drugs and painkillers This section expanded so much it got a page of its own:
Substance abuse, treatment, and recovery
[Back to Top]
Psychopathy and Personality Disorders
• When Your Child Is a Psychopath (Barbara Bradley Hagerty, The Atlantic, June 2017) 'Researchers shy away from calling children psychopaths; the term carries too much stigma, and too much determinism. They prefer to describe children like Samantha as having “callous and unemotional traits,” shorthand for a cluster of characteristics and behaviors, including a lack of empathy, remorse, or guilt; shallow emotions; aggression and even cruelty; and a seeming indifference to punishment. Callous and unemotional children have no trouble hurting others to get what they want. If they do seem caring or empathetic, they’re probably trying to manipulate you....Only in 2013 did the American Psychiatric Association include callous and unemotional traits in its diagnostic manual, DSM-5. The condition can go unnoticed because many children with these traits—who can be charming and smart enough to mimic social cues—are able to mask them....More than 50 studies have found that kids with callous and unemotional traits are more likely than other kids (three times more likely, in one study) to become criminals or display aggressive, psychopathic traits later in life. And while adult psychopaths constitute only a tiny fraction of the general population, studies suggest that they commit half of all violent crimes. Ignore the problem, says Adrian Raine, a psychologist at the University of Pennsylvania, “and it could be argued we have blood on our hands.”'
• What "Psychopath" Means (Scott O. Lilienfeld and Hal Arkowitz, Scientific American, 12-1-07) Psychopathic personality, often called psychopathy (pronounced “sigh-COP-athee”) or sociopathy. It is not quite what you may think.
• The Psychopath & The Sociopath: A Masterclass (video, Dr. Ramani Durvasula's long, fascinating explanation of Cluster B antisocial personality disorders, the stable maladaptive disorders, 2-5-20, 2 hrs. 35 min.). A fascinating lecture. Part of the MedCircle library of exclusive videos: https://watch.medcircle.com/browse (You can subscribe to the MedCircle series. Sociopath is a descriptive term but it is not a diagnostic term; that would be anti-social personality disorder.
• An Interview with a Sociopath (Antisocial Personality Disorder and Bipolar) (video, 32 min.) Dyshae is diagnosed with antisocial personality disorder. People with this condition are often referred to by the media as a “sociopath” or “psychopath”. Dyshae wants others to know that it is possible for a person with this disorder to become better adjusted to the world with the help of intensive therapy.
• Can You Call a 9-Year-Old a Psychopath? (Jennifer Kahn, NY Times Magazine, 5-11-12) "Currently, there is no standard test for psychopathy in children, but a growing number of psychologists believe that psychopathy, like autism, is a distinct neurological condition — one that can be identified in children as young as 5. Crucial to this diagnosis are callous-unemotional traits, which most researchers now believe distinguish “fledgling psychopaths” from children with ordinary conduct disorder, who are also impulsive and hard to control and exhibit hostile or violent behavior. According to some studies, roughly one-third of children with severe behavioral problems — like the aggressive disobedience that Michael displays — also test above normal on callous-unemotional traits. (Narcissism and impulsivity, which are part of the adult diagnostic criteria, are difficult to apply to children, who are narcissistic and impulsive by nature.)"
• Callous-Unemotional Traits in Children (Essi Viding, Observer, Association for Psychological Science, Oct. 2013) Researchers identify link to severe and violent antisocial behavior
• The Startling Accuracy of Referring to Politicians as 'Psychopaths' (James Silver, The Atlantic, 7-31-12) The characteristics that define clinical psychopathy are many of the same that make effective leaders. Two of the hallmarks of psychopathy are a calculating mind and a seemingly easy charm....In his landmark book on psychopathy, The Mask of Sanity, researcher Hervey Cleckley theorized that some people with the core attributes of psychopathy -- egocentricity, lack of remorse, superficial charm -- could be found in nearly every walk of life and at every level, including politics. Robert Hare, perhaps the leading expert on the disorder and the person who developed the most commonly used test for diagnosing psychopathy, has noted that psychopaths generally have a heightened need for power and prestige -- exactly the type of urges that make politics an attractive calling.
• Inside the Mind of a Psychopath – Empathic, But Not Always (Christian Keysers, Psychology Today, 7-24-13) Brain imaging shows psychopaths can empathize but do not empathize spontaneously
• Into the Mind of a Psychopath (Danielle Egan, Discover, 6-12-16) Fifty years ago, his chilling experiences as a prison psychologist led Robert Hare on a lifelong quest to understand one of humanity’s most fascinating — and dangerous — disorders.
• The Criminal Psychopath: History, Neuroscience, Treatment, and Economics (Kent A. Kiehl and Morris B. Hoffman, Jurimetrics, NCBI, 2011). "It is time for the criminal justice system to unmask the psychopath. Not necessarily to treat psychopathy as a potentially excusing condition, but rather to recognize the disproportionate psychopathic population in prison and to educate prison and parole officials so they can make better management and release decisions. It is also time to recognize that, contrary to conventional wisdom, psychopathic tendencies in juveniles may be amenable to treatment, at least for some part of the juvenile offender population. The etiological mysteries of psychopathy should not obscure the promise that some portion of this terribly costly population may be treatable. Such treatment would not only save taxpayers billions each year, it also would reduce the chances any one of us will become the psychopath’s next victim. The precise manner in which legislatures, judges, and prison officials might begin to address the problem of psychopathy is a complex question, implicating many difficult policy issues. But we cannot begin to address any of those difficult issues until we come to grips with the facts that psychopathy is real, it can be reliably diagnosed, and in the near future might even be treatable in some juveniles."
Organizations and other resources geared to mental health
• AP Stylebook: Entry on mental illness is added (AP, 3-7-13)
• Depression and Bipolar Support Alliance (DBSA)
• Faces and Voices of Recovery (people dealing with alcohol and drug problems)
• Family to Family Education Program. The NAMI Family-to-Family Education Program is a free, 12-week course for family caregivers of individuals with severe mental illness. (National Alliance on Mental Illness)
• Getting a Grip (Raymond Abbott, a licensed social worker, sees the humor in dealing with a difficult mental health client, in Pulse, 4-4-14)
• Grading the States: A Report on America's Health Care System for Adults with Serious Mental Illness (National Alliance on Mental Illness, 2009) See also Grading the States (NAMI report in brief, PR Newswire).
•••HealthCentral has sites (and blogs) in these categories, among others: ADHD, Alzheimer's, Anxiety, Asthma, Bipolar, Chronic Pain, Depression, Learning Disabilities, Schizophrenia, Sleep. HealthCentral's videos (a large, searchable, well-organized collection of videos from various sources) look very helpful, especially for those new to a condition.
• Intervoice: The international community for hearing voices
• The Kennedy Forum seeks to unite the health care system, and rally the mental health community around a common set of principles: Fully implement the 2008 parity law, bring business leaders and government agencies together to eliminate issues of stigma, work with providers to guarantee equal access to care, ensure that policymakers have the tools they need to craft better policy, and give consumers a way to understand their rights. Among Kennedy Forum Resources (toolkits, policy briefs, videos, and more). On parity, see Hard Conversations: Making the Most of Intervention Opportunities (6-28-17) and Parity Resource Guide for Addiction & Mental Health Consumers, Providers, and Advocates
• Many Voices (for people recovering from trauma and dissociation)
• McMan's Depression and Bipolar Web
• Mental Health: A Report of the Surgeon General (download, read online, or order this informative report)
• Mental Health By the Numbers (NAMI) Millions of Americans are affected by mental health conditions every year. Here are some facts about the prevalence and impact of mental illness.
• Mental Health First Aid
• Mental health services locator, by state (SAMHSA, Substance Abuse & Mental Health Services Administration)
• Mindset:Reporting on Mental Health (Canadian Journalism Forum on Violence and Trauma--part of a project created by Canadian journalists for journalists). Topics covered: When is stigma an issue for journalists? Towards best practice, Treatment and recovery, Legal issues and mental illness, Addiction and mental illness, Covering suicide, Journalist self-care. Geared to journalists but with links many nonjournalists may find helpful.
• MIRECC Educational products (Veterans Administration Mental Illness Research, Education, and Clinical Centers)
• National Addiction Rehab Locator
••• National Alliance on Mental Illness (NAMI, an important group for families of people who are mentally ill, provides advocacy, programs, and support for people whose lives are affected by serious mental illness) See Find Support & Programs (NAMI, National Alliance on Mental Illness)
• National Resource Center on Psychiatric Advance Directives (to plan for the possibility that one might lose capacity to give or withhold informed consent to treatment during acute episodes of psychiatric illness)
• Navigating the New Frontier of Mental Health and Addiction: A Guide for the 115th Congress (Kennedy Forum). You can also watch YouTube video (two hours) of Patrick J. Kennedy, Democratic leader Nancy Pelosi, and other advocates urge President Trump and the New Congress to take action on reducing suicide and overdose rates, and expanding coverage for mental health conditions.
• Patient Voices, a New York Times series of first-person accounts (in audio) of living with various chronic diseases, including bipolar disorder, O.C.D., and schizophrenia. Check out the whole list
• Psych Central’s links: Mental Health & Psychology Resources Online
• Postpartum Support International (PSI), excellent and extensive links
‘• Psychiatric Advance Directives (state-by-state info), National Resource Center on Psychiatric Advance Directives
• Psych Central (Dr. John Grohol's site, accessible mental health resources)
• Pulse: voices from the heart of medicine (personal accounts of illness and healing, fostering the humanistic practice of medicine, encouraging health care advocacy). See Pulse's archive of poems and stories
• Stop Stigma (SAMSHA) SAMHSA's Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health (ADS Center)\
• Support Groups: The changes and challenges they will bring to your life (listen to Christina J. Werdebaugh, on BlogTalkRadio)
• Maternal Mental Illness (resources on) (NY Times, PDF)
• Taking Action: A Mental Health Recovery Self-Help Educational Program (SAMSHA) Introduces a recovery educational curriculum that offers self-help concepts, skills, and strategies for adults with mental illness, including those dealing with substance use disorders. Promotes wellness, stability, recovery, and life transformation.
The system: issues affecting the treatment of mental illness
• The Twin Problems of Mental Health Care: Access and Affordability (Drew Altman, KFF, 12-10-24) KFF President and CEO Drew Altman analyzes the serious access and affordability challenges facing people with mental health problems and suggests the issue could be one of a few candidates for bipartisan action in the next Congress.
---The Mental Health Crisis Within the Mental Health Crisis (Drew Altman, KFF, 5-22-24) "The mental health crisis isn’t just about patients with mental illness or the teens struggling with emotional problems or individuals coping with loneliness, it’s also deeply and centrally about families.
"Any family with a family member experiencing mental illness knows all too well the serious stresses and strains that are part of the experience. But there was something else in the data that was even more striking: the number of families dealing with true crisis level events—a family member living on the street; making the brutal decision to institutionalize a loved one who is a threat to themselves or others; rushing a spouse or child to an ER with a drug overdose; self-harm; suicide attempts. And while we have inadequate services for families dealing with mental illness generally, we have even fewer services and supports for the families dealing with crisis events. The numbers of families experiencing a very serious mental health-related event is so large that it may constitute a crisis within the larger mental health crisis, and it’s one that does not receive enough attention."
• Cuomo Set Out to “Transform” Mental Health Care for Kids. Now They Can’t Get Treatment. Major investigation, series. (Abigail Kramer, THE CITY and photos by Sarah Blesener for ProPublica, 3-28-22)
---New York State Failed to Provide Legally Required Mental Health Care to Kids, Lawsuit Claims (Abigail Kramer, 4-13-22)
---New York Increases Funding of Mental Health Care for Kids, Including Cash Governor Says Will Reopen Hospital Beds (Abigail Kramer, 4-13-22)
---New York Let Residences for Kids With Serious Mental Health Problems Vanish. Desperate Families Call the Cops Instead. (Abigail Kramer, THE CITY, 6-8-22) Many residential treatment facilities for children in New York are shutting down, leaving families frustrated and scrambling to find mental health services. Some kids age out of care as they wait.
• The Americanization of Mental Illness (Ethan Watters, NY Times Magazine, 1-8-2010)
• Mental health disorders soar, but psychiatric bed count remains low (Katti Gray, Covering Health, Association of Health Care Journalists, 3-18-22) Mental and behavioral health disorders have reached a historic peak. And once again, the nation’s lack of inpatient psychiatric beds has become a major point of concern, a renewed focus of researchers and an important story for journalists to follow.
Reporters should note that even before the pandemic, those who had championed community-based rather than hospital-based care for people with mental illness had been heavily rethinking the wisdom of closing psychiatric hospitals. A system of community-based care has yet to be built out.
• The Largest Health Disparity We Don’t Talk About (Dhruv Khullar, NY Times, 5-30-18) Research indicates that Americans with serious mental illness die 15 to 30 years younger than those without. "We may assume that people with mental health problems die of 'unnatural causes' like suicide, overdoses and accidents, but they’re much more likely to die of the same things as everyone else: cancer, heart disease, stroke, diabetes and respiratory problems," Khullar writes, due in part to reduced or delayed use of care and physician biases against patients with mental illness.
• Oregon State Hospital fails to prevent staff injuries, investigation shows (Sydney Wyatt, Salem Statesman Journal, 10-28-22) "The Oregon State Hospital on Center Street in Salem is a psychiatric facility that currently serves about 549 patients with varying behavioral health conditions. Multiple assaults on hospital staff are detailed in a more than 1,100-page investigative report the Statesman Journal obtained from Oregon OSHA. The report shows employees face daily violent altercations with patients and frequently are injured." The genesis of the investigative report was an anonymous complaint by a hospital employee to Oregon OSHA in December 2019 about patient assaults resulting in staff injuries. Investigators found the state hospital failed to investigate about 78% of the frequent “violent altercations between employees and patients.”
• Pedophilia Is a Mental Health Issue. It's Still Not Treated as One (Shayla Love, Vice News, 8-24-2020) “This is a topic that scientists in the fields of mental health are not just uninterested in—it is actively repugnant....The goal of any modern, preventative treatment for pedophila should be to help people manage their sexual interests rather than try to change them, Cantor said....Online support groups for non-offending pedophiles have only recently entered the public eye. The most well-known group, the Virtuous Pedophiles, was formed in 2012 as a safe place for pedophiles to discuss their struggles and commitment to not offend." A sympathetic view of a problem society has silently censored--a problem for which solutions are now being sought. See also Shayla Love Tackles the Biggest Taboo of All (Christine Ro, Open Notebook, 12-8-2020) “I got a lot of really angry emails after the piece came out, from people saying I was a pedophile sympathizer and saying that the only treatment for them is a bullet or something like that.”
• Did a blockbuster drug make hundreds gamble compulsively? A legal fight may decide what science can’t confirm (Megan Thielking, STAT, 8-2-18) [Denise] Miley, 41, filed a lawsuit in January 2016 against the drug makers Bristol-Myers Squibb and Otsuka, alleging the drug — one of the best-selling in the world — caused compulsive behavior. The suit contends that the companies knew or should have known it could create such urges, and didn’t adequately warn the thousands of people in the U.S. who use the medication each year. Hundreds more people have since sued the companies, claiming that the drug caused them to gamble, eat, or have sex compulsively. And the Food and Drug Administration signaled its own concern in a 2016 safety warning, saying that uncontrollable urges to gamble, binge eat, shop, and have sex had been reported with use of the antipsychotic.
• Severe mental illness, untreated; tragic consequences (John Snook, StarTribune, 4-27-18) A man is charged with killing two people, months after being released from our care system. We can do better, and must. Our mental health system too frequently fails the most severely ill and seems weakest when tasked with caring for those who, because of their illness, are at the highest risk for committing such acts of violence. Snook, executive director of Treat or Repeat, talks about Treat or Repeat: A State Survey of Serious Mental Illness, Major Crimes and Community Treatment (Treatment Advocacy Center, Sept. 2017) as "an analysis of what each state does to ensure that the individuals with severe mental illness who have committed major crimes succeed once they return to the community." "We showed that, if provided with needed community supports, the likelihood that someone with mental illness who has been violent in the past will be violent again can be drastically reduced — from 40-60 percent recidivism to 10 percent or less in the states that adopt best practices."
• Abuses/issues in treatment of people with disabilities Links to many articles, resources.
• Time to Change: Let's end mental health discrimination (Time to Change's Media Guidelines, UK, to encourage realistic and sensitive portrayals of people with mental health problems)
• Could a judge's intervention help fix Louisiana's mental health care system? (Katherine Sayre, Nola.com, Times-Picayune, 10-3-18) 'Supporters of assisted outpatient treatment -- often known as AOT -- say that a civil court's intervention into a troubled patient's treatment can stabilize the individual and prevent a revolving door of hospitalizations and, in some cases, jail stays that hurt patients and cost taxpayers. AOT could potentially fill a gap in Louisiana, where budget cuts and privatization have shrunk the number of long-term inpatient hospital beds. Forty-seven states now have AOT laws, although not all are used to the same degree. Orleans Civil District Judge Kern Reese, a judge since 2001, said a hallmark of the program is the "black robe effect" -- an "aura of authority" the judge brings to a patient trying to stick to the court-ordered treatment plan, including taking medication, or facing another hospitalization.'
• Tax-Funded Mental Health Programs Not Always Easy To Find (Emily Bazar, California HealthLine, 4-27-18) In 2004, Californians approved the the state’s Mental Health Services Act (MHSA), originally known as Proposition 63, which imposes a 1 percent tax on personal income over $1 million to help counties expand mental health care services. The act has been “wildly successful” at improving the ability of counties to respond to the mental health needs of their residents, says the director of Alameda County's behavioral health services. A 2016 compilation of MHSA-funded programs across the state lists page after page of offerings that address homelessness, suicide, caregivers, veterans, children and dozens of other topics and populations, including scholarships for college students pursuing degrees in mental health. But what’s available — and to whom — depends on your county. And researching county programs and determining whether you or your loved ones qualify may not be easy.
• Can I Trick My Brain-Damaged Brother Into Taking His Meds? (Kwame Anthony Appiah, The Ethicist, NY Times, 10-16-18) The magazine’s Ethicist columnist on tricking a brain-injured relative into taking needed psychiatric medication and helping a schizophrenic roommate. "If people have some basic measure of rational capacity, they are normally entitled to make decisions for themselves, even ill-advised ones." Read the comments as well as the main text.
• How a Bad Law and a Big Mistake Drove My Mentally Ill Son Away (Norman J. Ornstein, NY Times, 3-6-18) Must reading. Mr. Ornstein succinctly explains what's wrong with the system (the problem with the standard of “imminent danger to oneself or others”; the 90 days an individual may be held, which isn't long enough to provide "meaningful or sustained treatment"; the "cruel and ineffective" system that "keeps loved ones from any involvement in the treatment of people with serious mental illness, especially those who do not know or believe they are ill"; the need to treat people who are seriously mentally ill but not dangerous, yet recognize that not properly treating those who might become violent could be lethal; ,and what we must do to fix it. "What is really required is a comprehensive treatment framework and the money to pay for it." And he writes about what that might be. And of course "To reduce the incidence of mass murders — and suicides — we have to reform the gun laws.""States need to adopt “red-flag” laws, which allow police officers and family members to petition a court to bar dangerous individuals from possessing guns."
• Special Report: In Louisiana jail, deaths mount as mental health pleas unheeded (Melissa Fares, Charles Levinson, Reuters, 5-31-18) The East Baton Rouge Parish Prison, a squat brick building with low-slung ceilings and walls sometimes smeared with feces, is the face of a paradigm shift: penitentiaries as mental health care providers. Across the United States thousands of jails are sheltering a wave of inmates accused of crimes and serving time while suffering from illnesses ranging from depression to schizophrenia. A long read.
• On Back Roads Of Appalachia’s Coal Country, Mental Health Services Are As Rare As Jobs (Vickie Connor, Kaiser Health News, 10-17-17) Every other month, Tanya Nelson travels 32 miles from the heart of Appalachia’s coal country for an appointment with the nearest psychiatrist for therapy and to renew prescriptions. But the commute, which should take less than an hour through the winding mountain roads of southern West Virginia, consumes her entire day. Nelson, 29, needs treatment for bipolar disorder, depression and anxiety. But she does not drive, so she must use a van service to keep her appointments. It makes numerous stops along the highway, picking up other travelers, and usually doesn’t return to her home in New Richmond, W.Va., until day’s end.
• America's Largest Mental Hospital Is a Jail At Cook County Jail, where a third of those incarcerated suffer from psychological disorders, officials are looking for ways to treat inmates less like prisoners and more like patients. Pre-bail processing here takes place entirely underground.... All new detainees at the Cook County Jail go through mental health evaluations....Although the effects varied from person to person, many patients with serious.... States and, by default, one of the largest mental-health facilities in the country.
• Mental health patients are being treated as criminals and sent to prisons rather than hospitals (Patrick Cockburn, Independent, 4-21-17). The old asylum system was dismantled but nothing was put in its place to care for people unable to look after themselves who are a potential danger to themselves and others. The prison systems in the US and UK have replaced psychiatric hospitals as the place where people suffering from severe mental illness are most likely to find themselves.
• With psychiatric beds full, mentally ill in Maryland are stuck in jails (Michael Dresser, Baltimore Sun, 6-8-16) The state Department of Health and Mental Hygiene, which spurned a consultant's warning four years ago, does not have enough beds or staff to treat new patients, officials say. The shortage comes as 80 percent of those admitted to such facilities are arriving via the criminal justice system.
• In solitary, with mental illness: Devon Davis’ life alone, in prison and outside (Taylor Knopf, News & Observer, 5-28-16) Part 1 of a two-part series on how North Carolina's prison system used solitary confinement to discipline inmates for even minor infractions. “Davis was one of more than 2,000 North Carolina inmates released last year after being imprisoned with a mental illness. He was one of hundreds released directly from solitary confinement within a state prison.” Searching for stability (Part 2, 5-30-16) Without a home, with little support, Devon Davis tries to find his way. Video: Out of solitary, but still alone Devon Davis discusses his experiences in solitary confinement and his attempts to get settled after being released from prison. H/T to Joseph Burns, who wrote For N.C. reporter, news brief led to series on solitary confinement, mental illness (Covering Health, 7-17-17). "In most states, care for those with behavioral health problems is so poor that the nation’s prisons have become the default treatment centers for many of the most vulnerable mental health patients. As Congress wrestles with plans to cut funding for Medicaid, many observers are calling for more coverage."
• The Best Reporting on Mental Illness in Prisons (Christie Thompson, ProPublica, 8-19-13) Links to "some of the best deep-dive reporting on the mentally ill in U.S. prisons." See also the comments.
• How My Panicked Trip to the ER Exposed a Major Flaw in Mental Health Care As soon as the doctors confirmed there was nothing physically wrong with me, they sent me on my way—and I’m far from the only one who has been ignored. “It isn’t an illness or injury that you can physically see,” says Dawn Daum, who has worked as an ER mental health evaluator and is the co-editor of the website Parenting with PTSD. “For some reason, there is an unspoken attitude that it is acceptable and encouraged to seek help with a physical ailment, such as a broken bone; however, if the complaint is in regards to mental or emotional pain, it is unacceptable for a person to seek help.”
• Mental Health Inc: How Corruption, Lax Oversight and Failed Reforms Endanger Our Most Vulnerable Citizens by Art Levine. "By some measures, 20 percent of Americans have some sort of mental health condition, including the most vulnerable among us―veterans, children, the elderly, prisoners, the homeless. With Mental Health, Inc., award-winning investigative journalist Art Levine delivers a Shock Doctrine-style exposé of the failures of our out of control, profit-driven mental health system, with a special emphasis on dangerous residential treatment facilities and the failures of the pharmaceutical industry, including the overdrugging of children with antipsychotics and the disastrous maltreatment of veterans with PTSD by the scandal-wracked VA.Levine provides compelling narrative portraits of victims who needlessly died and some mentally ill people who won unexpected victories in their lives by getting smart, personalized help from “pyschosocial” programs that incorporate safe and appropriate prescribing, along with therapy and social support. He contrasts their stories with corrupt Big Pharma executives and researchers who created fraudulent marketing schemes."
• Antipsychotic Drugs: Side Effects May Include Lawsuits (Duff Wilson, NY Times, 10-2-10). writes that second-generation ("atypical") antipsychotic drugs, which pharmaceutical companies have marketed heavily as being safer, are the subject of lawsuits, unveiling documents revealing questionable marketing tactics about drugs for which side effects are still being reviewed.
• Trump’s Pick for Mental Health ‘Czar’ Highlights Rift (Benedict Carey and Sheri Fink, NY Times, 5-24-17) The White House’s choice for the first person to fill the position of federal mental health “czar” has already been divisive, exposing longstanding rifts within the field that may be difficult to mend. "A central tension in the debate is between the medical model of psychiatry, which emphasizes drug and hospital treatment...and the so-called psychosocial, which puts more emphasis on community care and support from family and peers....For partisans, this rift is tribal: Those on the medical side are appalled at the lack of hospital beds and aggressive court-ordered — i.e. involuntary — drug treatment for people most in need, particularly those with schizophrenia, many of whom do not believe they need treatment and end up in prison. On the other side, advocates, former patients, and some doctors argue that medical treatment by itself — beds and meds, as they call it — is often not sufficient and, when forced, can alienate the people it is meant to help....Whichever direction the new mental health czar chooses, most agree that the new position at least concentrates accountability for change in one place."
• Can You Call a 9-Year-Old a Psychopath? (Jennifer Kahn, NY Times Magazine, 5-11-12)
Compulsory community/outpatient care for mental illness. Norman Bauman provided these links and comments:
---Forced Treatment (Policy Documents and Where We Stand, Bazelon Center for Mental Health Law) Material from many angles, which "tend to be critical of compulsion, but then again the evidence tends to be negative" (Bauman)
---Community treatment orders for patients with psychosis (OCTET): a randomised controlled trial (Tom Burns et al., Lancet, 3-26-13)
---An Explanation of Kendra's Law (New York State Office of Mental Health, 1999) Norman: "What this summary doesn't tell you is that Kendra Webdale was pushed in front of a subway train by Andrew Goldstein, a graduate of Bronx High School of Science who developed schizophrenia, and who had repeatedly gone to emergency rooms telling them that he couldn't control his symptoms and was turned away....Kendra's Law wouldn't have helped Kendra. See Bedlam on the Streets (Michael Winerip, NY Times Magazine, 5-23-99). Norman again: "As you might expect from a law named after a tragic victim, it was based more on emotion than evidence. The worst fears of the civil libertarians didn't come to pass, and the final result of Kendra's law, which was applied to about 2,000 patients, mostly in NYC, was that they did somewhat better, but it may have been because they were given a lot more resources rather than the compulsive aspects of the law." Posted on AHCJ listserv and reprinted by permission of NBauman.
• Cost of not caring: Nowhere to go (Liz Szabo, in excellent series in USA TODAY, 7-21-14 ). PART 1. Mental health system drowns from neglect. The financial and human toll for neglecting the mentally ill. First story: A man-made disaster: A mental health system drowning from neglect. “We have replaced the hospital bed with the jail cell, the homeless shelter and the coffin” (Rep. Tim Murphy, R-Pa.) States have been reducing hospital beds for decades, because of insurance pressures as well as a desire to provide more care outside institutions. Tight budgets during the recession forced some of the most devastating cuts in recent memory, says Robert Glover, executive director of the National Association of State Mental Health Program
• Cost of not caring: Stigma set in stone (Liz Szabo, USA TODAY) PART 2. People with mental illness suffer in sick health system. Chapter 1: A separate and unequal system. People with mental illness face legal discrimination. “'There is no other area of medicine where the government is the source of the stigma.' ” Rep. Tim Murphy, Rep. PA. Chapter 2: Lost in darkness. Many wait nearly a decade for treatment. "“'If someone had listened to me the way that psychiatrist listened to me in jail. I think maybe my illness wouldn't have gotten that far.'” Chapter 3: Working for change. Advocates chip away at discriminatory policies. “'Every parent I know has to fight for treatment for their child.'” Chapter 4: Overcoming the shame: Speaking up heals old wounds. “'Where we are at is where the cancer community and HIV community were 25 years ago.'” NFL player Brandon Marshall
• Denied (Scott Pelley and others, 60 Minutes, 8-2-15) "The vast majority of claims are routine but the insurance industry aggressively reviews the cost of chronic cases. Long-term care (chronic, expensive cases) is often denied by insurance company doctors who never see the patient. As a result, some seriously ill patients are discharged from hospitals over the objections of psychiatrists who warn that someone may die." Insurance doctors like "Dr. Jack" profit from high denial rates.
• 'If Only They Had Treated Him' (Wayne Drash, CNN series, America's Mental Health Crisis, with Brandon Ancil, video, and John Nowak, photography, August 2014).
• Mental wellness warriors: Fighting for those who need it most (Wayne Drash, CNN series on America's Mental Health Crisis, 1-17-15)
• 'My son is mentally ill so listen up' (Wayne Drash, CNN; video and photos by Evelio Contreras, 12-13) He is 14 and hears voices. He's been hospitalized more than 20 times. Stephanie Escamilla is tired of seeing the country focus on the mentally ill only when there's a national tragedy. So she and her son are telling their story — of a family on the brink.
• Mental illness cases swamp criminal justice system (Kevin Johnson, USA Today) PART 3. Mental illness cases swamp criminal justice system. On America's streets, police encounters with people with mental illnesses increasingly direct resources away from traditional public safety roles. Chapter 1: Hordes of inmates are ill. Fractured system plagued by problems. “They end up here (the criminal justice system), because we are the only system that can't say no.” ~Cook County sheriff Tom Dart. Chapter 2: Taken away in cuffs. Exhausted cops transport those needing help all over the state. Chapter 3: A gunshot, and a teen dies. Not all officers are trained to deal with mental patients. Chapter 4: Lessons from a fatal shooting. A call goes out for special officer training. Chapter 5: A call for help, then Navy Yard. Aaron Alexis and the 'vibrations' in his body
• A warning, a gun sale and tragic consequences (Ann E. Marimow, Washington Post, 3-6-17) “I’m begging you as a mother, if she comes in, please don’t sell her a gun.” Despite a mother’s plea, her mentally ill daughter was sold a firearm. Here’s why she sued. On gun regulations, a partisan divide: The House and Senate voted largely along party lines in February to get rid of Obama administration regulations aimed at blocking mentally ill people from passing federal background checks for gun purchases. For more on the politics, read the sidebar next to the main story.
• Finding a Bed in Bedlam (Jo Marie Reilly, Pulse" Voices from the heart of medicine, 5-8-15)
• 40,000 suicides annually, yet America simply shrugs (Gregg Zoroya, USA Today) There's a suicide in the USA every 13 minutes.
• Law creates barrier to getting care for the mentally ill (Meg Kissinger, Milwaukee Journal-Sentinel 12=10=11). Forty years ago, a new legal standard for mental health commitment emerged from a Milwaukee lawsuit to become the law of the land. It has proved to be tragically inadequate. The problem with leaving it up to a person to decide if he or she wants psychiatric care is that not everyone with mental illness knows they have it.
• Mental disorders keep thousands of homeless on streets (Rick Jervis, USA Today) Thousands with mental illness end up homeless, but there are approaches that can help out. Dorothy Edwards hugs her 8-year-old dog, a shepherd-pit bull mix that helped protect her when she lived on the streets.
• Mindset Media Guide: Reporting on Mental Health (free download). This Canadian website for journalists covering mental health stories covers these topics among others, online: Why is stigma an issue for journalists? towards best practice; treatment and recovery; legal issues and mental illness; addiction and mental illness; covering suicide; journalist self-care; recent events; resources and reading.
• ‘Rosemary: The Hidden Kennedy Daughter,’ by Kate Clifford Larson (Meryl Gordon's review, NY Times, 10-6-15). This review gives a once-over of the Kennedy's unluckiest family member, whose life story is told in Rosemary: The Hidden Kennedy Daughter by Kate Clifford Larson. "What makes this story especially haunting are the might-have-beens."
• Solutions to woes of mentally ill exist but aren't used (Liz Szabo, USA TODAY) Millions could be helped if programs were put into place.