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God's Psychiatrist

on Monday, 08 July 2013.

Funny portrayal of a psychiatrist analyzing some events in the Old Testament

God's Psychiatrist

By H. Steven Moffic, MD

Chapter 1. A Psychiatrist in Biblical Times

In Genesis, it is described that man, and then presumably woman in a first example of matchmaking, is created in the image of God. Imagine a modern day psychiatrist time traveling back to observe this creation. If you don’t believe in such a God, but are a parent, think of a child created, at least half genetically speaking, in your image.

As holy as it may seem to be created in the image of a God, would a psychiatrist think that this was mentally healthy? What happens to the children of parents who want their children to fulfill their own dreams? Could it be too much of a narcissistic wish and expectation to be created in anyone’s image? Wouldn’t this make normal separation and individuation more difficult, the psychiatrist wondered?

Indeed, the psychological challenges and problems for Adam and Eve emerge quickly in the Garden of Eden. The psychiatrist observing this scenario wondered about offering a walk, as Freud did about a century ago with Mahler, to discuss the temptation and symbolic meaning of the Serpent and the Tree of Knowledge. But the psychiatrist wondered if this was an impossible paradox to resolve. Without knowledge, how does one understand the risks of obtaining knowledge?

So Eve goes ahead, and she and Adam are banished from the Garden in shame. If our psychiatrist could have met them in this wider world, perhaps they could have processed their shame and the current status of their relationship before they had children. Instead, the result is 2 sons, Cain and Abel, who portray the first sibling conflict and competition, so severe that Cain murders Abel.

After this tragedy, history seems to progress adversely until Noah. Noah is said to be the best of his time. In the Ark that he builds, his family, animals, and himself survive drastic environmental and climate changes. If a psychiatrist were also on the Ark, there would have been ample time to discuss how Noah felt about the responsibility of saving the world, and how he might prepare himself for a different future. As it turns out, he becomes drunk afterward. Noah might have needed detox and Alcoholic Anonymous; his family might have sought support from Al-Anon. However, just like the lives of so many modern day celebrities, their lives and the story goes on without completing treatment.

The next major figure is Abraham. No one claims to know, not even himself, why he is chosen to start a new religion. Later on in his life, sibling rivalry emerges again, but now between stepbrothers. After Abraham has his son Ishmael by the handmaiden, Hagar, Abraham and his wife Sarah have their own son, Isaac. Can’t you just predict the need for some challenging family therapy? Instead, Sarah, with the apparent approval and support of God, orders Ishmael to be banished. Abraham acquiesces, and God, to seemingly even things out a bit, says that Ishmael will start his own Kingdom, which many have taken to become the Arab people.

Abraham is later asked to sacrifice Isaac. Any psychiatrist might say that at times of exasperation, a parent might think of sacrificing their child. But this time it includes the actual preparation, without the apparent knowledge, of Sarah. Isaac is spared at the last minute, but to a psychiatrist, it might seem that he suffered PTSD. Sarah may have died soon afterward from the shock of grief.

Without treatment, as family problems are wont to do, the sibling conflicts continue in Isaac’s sons, Esau and Jacob, and then again in Jacob’s sons. Esau also goes off in exile, perhaps to start what will become the Roman people.

This story should be enough to call forth a psychiatrist, shouldn’t it? Finally, do we see the prototype of God’s psychiatrist in Jacob’s son, Joseph? Though Jacob’s favoritism, culminating in his giving Joseph the coat of many colors, seems to produce excessive narcissism, Joseph overcomes the trauma of being sold by his brothers and given jail time in Egypt, to use his prophetic interpretation of dreams. He attributes this skill to God, succeeding beyond anyone’s wildest dreams in a new culture, in which he prepares successfully for climate change, forgives his brothers, and is united with his father. After this family forgiveness, the cycle is broken and there is just “normal” sibling rivalry depicted in the Old Testament.

With the psychological path cleared in one way, but challenging in another, Moses arrives. A psychiatrist in the court might wonder if his stuttering was a consequence of an unusual child rearing, both in the Egyptian court, where he is adopted, and with the surreptitious involvement of his own family. Maybe he was dealing with buried anger, too. Moses, despite being so humble, has several outbursts of anger, which cost his entry into the Promised Land. Would anger management and/or a prn calming medication have helped him? If he were calmer, perhaps he would have recommended group psychotherapy for those disgruntled among his people, and maybe then sought psychoanalysis for himself. Following the death of Moses, the Old Testament ends.

Chapter 2. Psychiatry in the Common Era


Let’s go on to the Rabbis who replaced Jewish priests in the diaspora outside of Israel after the beginning of the Common Era. They seemed to grasp some therapeutic principles that would help sustain the Jewish people and keep them together over the next 2 millennia, despite pogroms, exiles, and most recently, the Holocaust. They came to interpret the Old Testament in different ways and on many levels, including the Talmud, Midrash, Kabalah, weekly Torah study around the world, and pastoral counseling. In the early Middle Ages, one particular Rabbi—Maimonides—who was a general physician and philosopher all in one, conveyed basic concepts of mental well-being, supportive psychotherapy, and even the basis of our most popular and evidence-based therapy, cognitive-behavioral psychotherapy.1

Nevertheless, there was still no formal field of psychiatry, that is, until a Jewish physician emerged about a century ago to complement the work of Kraepelin. Sigmund Freud, after a childhood as an honor student in Jewish religious schools, went on to take the new field of psychiatry to a different level with his psychoanalytic theories.

Like Joseph, Freud arrived at his conclusions after analyzing his own dreams. The difference is that Freud analyzed the conflictual issues in his dreams, and Joseph analyzed their prophetic meanings. In the ensuing therapeutic process, different levels of interpretation paralleled the Rabbis’ interpretation of the teachings in the Torah.

Was Freud God’s psychiatrist at long last? Not likely. Actually, Freud’s views may reflect why a psychiatrist was not around from the beginning of humanity in Biblical times. Freud, though publicly valuing his Jewish cultural background and involved with B’nai B’rith meetings in Vienna, was famous (or infamous) for claiming that religion was an illusion, an opium for the masses, and that belief in God was a matter of the transference of feelings toward one’s parents.

Freud also seems to underestimate anti-Semitism, which labeled psychoanalysis as that “Jewish science,” only leaving his home at the last minute when his daughter’s life was threatened. Since Jewish theology values action over thoughts and beliefs, Freud’s actions—to find new ways to heal people—couldn’t be more Jewish. What did it mean, then, that Freud died on Yom Kippur, the Day of Atonement, in 1939? And if he was thinking of his death in the physician-assisted morphine mental state, did he reassess his feelings about God?

What about that other famous psychiatrist from Vienna, who studied some with Freud? That was Viktor Frankl. In one of life’s ironies, he lived for a time in close proximity to Hitler. What if he, or another psychiatrist, had at one point been able to treat Hitler during his troubled childhood? As it turned out, however, Dr Frankl2 was about to go to America, only to have an existential crisis:

Should I foster my brainchild, logotherapy . . . or should I concentrate on my duties as a real child of my parents and stay by them?2

He returned home to find the letters of the Ten Commandments stating to honor thy father and mother. He let his Visa lapse. Sent not long after to Auschwitz, he became a sort of concentration camp psychiatrist, struggling to give meaning to the struggle to survive. That meaning was to see his wife again and to lecture about the psychological lessens learned. Only the latter came to pass. After the war, he resettled in Vienna and remarried a Christian woman. He soon published the perennial best seller, Man’s Search for Meaning, and established Logotherapy, a “therapy of meaning.”

Although I was trained in Freudian psychotherapy in the early 1970s, by the end of my clinical career, I came to follow the path of Freud to Frankl by focusing on the meaning of life for the decreasing amount of time I had with each patient.3

Did Dr Frankl end up believing in a God? He never would say.

In our time, it seems that the number of psychiatrists who believe in a God are increasing, parallel with the decreasing influence of Freud’s ideas. Jewish psychiatrists, although still prominent in the newer areas of group psychotherapy, cognitive therapy, understanding brainwashing, and even Freud’s predicted psychopharmacology, are nevertheless decreasing in their relative numbers.

Perhaps the notable example of a Jewish psychiatrist who clearly and overtly believes in God is Dr Abraham Joshua Twerski, who is also a Rabbi and scion of a Hasidic dynasty, and specializes in substance abuse. For a comparable Christian psychiatrist, we can cite the late Dr E. Mansell Pattison, who was also a minister.

Chapter 3. The Moral of the Story

What, then, is the moral of this tale, as Hannah, my grandchild of 2 Rabbis, would ask? Just in time, a valued teacher and colleague asked, “Isn’t God a Psychiatrist”? If God is a psychiatrist and we psychiatrists were also created in God’s image, and if we psychiatrists have come currently to view religion and psychiatry as more overlapping than conflictual, then together we can work to help and maybe even improve human nature. Amen.

References1. Pies RW. The Judaic Foundations of Cognitive-Behavioral Therapy. Bloomington, Ind; iUniverse; 2010.
2. Scully M. Viktor Frankl at Ninety: An Interview. First Things. April 1995. http://www.firstthings.com/article/2008/08/004-viktor-frankl-at-ninety-an-interview-18. Accessed April 1, 2013.
3. Moffic HS. The meaning of life in a 15-minute med check. Psychiatr Times. May 19, 2011. http://www.psychiatrictimes.com/bipolar-disorder/content/article/10168/1864201. Accessed April 1, 2013.

- See more at: http://www.psychiatrictimes.com/god’s-psychiatrist-april-fool’s-tale-3-chapters/page/0/2#sthash.cfTiiQbN.dpuf

- See more at: http://www.psychiatrictimes.com/bipolar-disorder/god’s-psychiatrist-april-fool’s-tale-3-chapters#sthash.1Ku3jKyS.dpuf

6 Keys To Building Resilience

on Wednesday, 12 June 2013. Posted in General

Resilience key to dealing with depression or bipolar disorder

6 Keys To Building Resilience

Tactics for building resiliance include:

1. Learn how to regulate your emotions

2. Adopt a positive but realistic outlook

3. Become physically fit

4. Accept challenges

5. Maintain a close and supportive social network

6. Observe and imitate resilient role models

Iron Man 3: Reconciling Psychiatry’s Warring Camps

on Sunday, 28 July 2013.

Tony Stark could really use bStable to figure out what's going on in his head...

Iron Man 3: Reconciling Psychiatry’s Warring Camps
 

[Spoiler alert: You might choose to wait to watch the movie—or read this article. —Eds.]

In Iron Man 3, former arms manufacturer Tony Stark is a superhero who aspires to facilitate world peace. In the process, he wages a one-person war against villains who aim to overthrow the powers that be and attain world dominion. Given his mighty missions, who would expect Tony Stark (the Iron Man) to propose peace between warring schools of psychiatry and to attempt to reconcile the armies of the mind with the armies of the brain?

No one, probably—and that’s what makes this twist in Iron Man 3 so intriguing. Tony Stark embarks on a psycho-philosophical quest when he asks if he defines Iron Man, because he manufactures Iron Man’s suit, or if his personal identity is subsumed by this intense public persona. Jungians, Eriksonians, Kohutians—and others—will delight in this dilemma.

Admittedly, Iron Man 3 has a much more involved, action-oriented plot. The psychiatry subtext is just that: a subtext. Still, this subtext speaks directly to neuropsychiatrists, psychopharmacologists, psychotherapists, just plain psychiatrists—or whatever they call themselves. The epilogue that begins after the film ends fleshes out this footnote.

Neuropsychiatry figures prominently in this 2013 riff on the Marvel Comics 1963 character—but so do aerospace engineering and international politics. The MacGuffin of the movie is a substance known as “Extremis.” Extremis enters the CNS via a virus and binds with the brain, promoting DNA changes that send electronic and neurochemical signals to weaponize the body, impart superhuman strength, and make machines move by mind-power alone.

Iron Man 3 does not dwell on Extremis, but comic book fans will recall the original story line in which Extremis facilitates direct brain-based connections with inanimate armor.1 That process allows Tony Stark to become one with his armor. He can now accomplish humanly impossible feats. In other words, Tony becomes Iron Man, both in body and in mind. Hence, his existential identity question emerges.

Unlike some superheroes, Tony Stark is a mere mortal, even though he is a genius inventor and industrialist. He battled the bottle and was a philanderer, but he abandoned his wanton ways to become a philanthropist who devotes his vast fortune to saving the world, even (or especially) if it means putting his own life in peril. Iron Man’s red armor recollects the red cape of the Man of Steel, for both Iron Man and Superman fly through the air. However, Superman’s powers are inherent, while Iron Man’s abilities depend on man-made machinery.

Appropriately and convincingly, Stark is played by actor Robert Downey Jr, whose own struggles with substance abuse were well publicized. Downey’s back-story enhances the casting choice, as does his ability to combine tongue-in-cheek comedy with action-adventure swagger.2

Like Batman, Iron Man fetishizes gadgets. Both possess vast wealth. Unlike Batman, Iron Man designs and builds his own contraptions without relying on his butler. Stark understands neurotransmitters enough to explain how Extremis operates. His conversation sounds fanciful, except for the fact that strikingly similar engineering feats are already in the works.

Minds can communicate with machines in real life, and not just in reel life. For instance, recent news reports revealed that electrode-laden caps allow wearers to communicate with a plane via the mind alone.3 The cap-wearer makes the plane change course when he or she concentrates on making a fist with one hand or the other. The Defense Advanced Research Projects Agency has been experimenting with such technologies for years. Private industry will soon bring related bioengineering feats to commercial markets. Such One Step Beyond–style “mind-control” was previously the province of parapsychology, but no more.

Still, the Iron Man 3 story itself remains science fiction. In Iron Man 3, Extremis has supercharged an army of invaders. World powers and underground conspirators are in hot pursuit of this mysterious substance that can potentiate their evil goals. They are ready to battle Iron Man and anyone else who tries to obstruct their plans to overtake humanity. A once-suicidal scientist, an easily swayed botanist, and a drug-addicted actor figure into the fast-paced plot.

After the movie ends, and after Tony Stark has disarmed his enemies and rescued his love object, spectators are in for another surprise: an epilogue involving Tony Stark and Dr Bruce Banner. The epilogue screens after the last credits roll, when the film is officially over.

In this scene, Tony sits on a sofa, wearing his “civvies,” his armor out of sight. Tony recounts his triumphs and travails. Superhero fans know Dr Banner (Mark Ruffalo) as the physicist who turns into The Hulk whenever his anger is aroused. He becomes big, green, and amygdala-driven. Superficially, this scene looks like a teaser for the forthcoming Marvel film, Avengers 2, which features both Iron Man and The Hulk. However, psychiatrists who listen with their third ear hear tacit messages embedded in the dialogue, replete with reflections about rifts in mental health care.

Tony talks to Dr Banner “. . .and thank you, by the way, for listening. There’s something about getting it off my chest and putting it out there in the atmosphere, instead of holding this in. I mean, this is what gets people sick. . . . Wow, I had no idea you’re such a good listener. . . to be able to share all my intimate thoughts, my experiences with someone . . . it just cuts the weight of it in half. . . and the fact that you’re able to help me process . . . you heard me?”

At that moment, the camera shifts to Dr Banner, who sits in a chair behind the couch. How curious! A film that revolves around neuropsychiatry, DNA alterations, neurotransmitters, and bioengineering comes around full circle to highlight the importance of talking, processing, communicating, and sharing.

Tony Stark never implies that talking it out would have changed anything—or that he wanted to change anything. (Thank goodness, for that would deprive both him and his audience of both past and future action-adventures!)

Yet he endorses the value of making meaning out of life experiences, including save-the-world kind of experiences. He affirms his belief that psychotherapy can contribute to this philosophical pursuit. Unfortunately, he has chosen someone who is “not that kind of doctor.” It’s not just that Dr Banner is a physicist, and a hard scientist, but Dr Banner tells Tony that he does not have the “temper . . . or temperament” to do that kind of doctoring: Dr Banner turns into The Hulk when his emotions are aroused—not a good trait for a therapist.

DISCLOSURES

Dr Packer is Assistant Clinical Professor of Psychiatry and Behavioral Sciences at the Albert Einstein College of Medicine, Bronx, NY. She is also in private practice in New York City. She is the author of Superheroes and Superegos: Analyzing the Minds Behind the Masks (Santa Barbara, CA: Praeger/ABC-CLIO; 2010) and several other books, for which she receives royalties.

REFERENCES

1. Ellis W, Granov A. Iron Man Extremis Director’s Cut. New York: Marvel Comics; 2010.

2. Packer S. Superheroes and Superegos: Analyzing the Minds Behind the Masks. Santa Barbara, CA: Praeger/ABC-CLIO; 2010.

3. Kingson JA. An old Torah, older sunken boats and a seriously old primate. New York Times. June 10, 2013. http://www.nytimes.com/2013/06/11/science/old-sunken-boats-an-older-torah-and-a-seriously-old-primate.html?_r=0. Accessed July 12, 2013.

- See more at: http://www.psychiatrictimes.com/neuropsychiatry/iron-man-iii-reconciling-psychiatrys-warring-camps?GUID=027D74F9-294C-4019-B4F6-6C862BE2E981&rememberme=1&ts=27072013#sthash.LMZFrt8J.dpuf

Anxiety

on Saturday, 26 January 2013.

bStable Enables Symptom Monitoring for Patients Diagnosed with Anxiety Disorders but How Many People Suffer From Anxiety Disorders?

Anxiety

From the NIMH:

Anxiety Disorders

Anxiety disorders include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and phobias (social phobia, agoraphobia, and specific phobia).

  • Approximately 40 million American adults ages 18 and older, or about 18.1 percent of people in this age group in a given year, have an anxiety disorder.
  • Anxiety disorders frequently co-occur with depressive disorders or substance abuse
  • Most people with one anxiety disorder also have another anxiety disorder. Nearly three-quarters of those with an anxiety disorder will have their first episode by age 21.5

Panic Disorder

  • Approximately 6 million American adults ages 18 and older, or about 2.7 percent of people in this age group in a given year, have panic disorder.
  • Panic disorder typically develops in early adulthood (median age of onset is 24), but the age of onset extends throughout adulthood.
  • About one in three people with panic disorder develops agoraphobia, a condition in which the individual becomes afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack.

Obsessive-Compulsive Disorder (OCD)

  • Approximately 2.2 million American adults age 18 and older, or about 1.0 percent of people in this age group in a given year, have OCD.
  • The first symptoms of OCD often begin during childhood or adolescence, however, the median age of onset is 19.

Post-Traumatic Stress Disorder (PTSD)

  • Approximately 7.7 million American adults age 18 and older, or about 3.5 percent of people in this age group in a given year, have PTSD.
  • PTSD can develop at any age, including childhood, but research shows that the median age of onset is 23 years.
  • About 19 percent of Vietnam veterans experienced PTSD at some point after the war. The disorder also frequently occurs after violent personal assaults such as rape, mugging, or domestic violence; terrorism; natural or human-caused disasters; and accidents.

Generalized Anxiety Disorder (GAD)

  • Approximately 6.8 million American adults, or about 3.1 percent of people age 18 and over, have GAD in a given year.
  • GAD can begin across the life cycle, though the median age of onset is 31 years old.

Social Phobia

  • Approximately 15 million American adults age 18 and over, or about 6.8 percent of people in this age group in a given year, have social phobia.
  • Social phobia begins in childhood or adolescence, typically around 13 years of age.

Agoraphobia

Agoraphobia involves intense fear and anxiety of any place or situation where escape might be difficult, leading to avoidance of situations such as being alone outside of the home; traveling in a car, bus, or airplane; or being in a crowded area.

  • Approximately 1.8 million American adults age 18 and over, or about 0.8 percent of people in this age group in a given year, have agoraphobia without a history of panic disorder.
  • The median age of onset of agoraphobia is 20 years of age.

Specific Phobia

Specific phobia involves marked and persistent fear and avoidance of a specific object or situation.

  • Approximately 19.2 million American adults age 18 and over, or about 8.7 percent of people in this age group in a given year, have some type of specific phobia.
  • Specific phobia typically begins in childhood; the median age of onset is seven years.

Awesome Bipolar Disorder Infographic!!

on Friday, 14 June 2013. Posted in General

Created by Deyanara Riddix of Nursingschoolhub.com - thanks!

Awesome Bipolar Disorder Infographic!!

What a great way to summarize bipolar disorder.

Great job Deyanara - all the way from West Bengal, India!

http://www.nursingschoolhub.com

http://www.nursingschoolhub.com/bipolar

 

Bipolar Disorder Medications

on Sunday, 03 February 2013.

Mood Stabilizer Sometimes with antipsychotics and antidepressants

Bipolar Disorder Medications

From the NIMH...

Mood stabilizers

People with bipolar disorder usually try mood stabilizers first. In general, people continue treatment with mood stabilizers for years. Lithium is a very effective mood stabilizer. It was the first mood stabilizer approved by the FDA in the 1970's for treating both manic and depressive episodes.

Anticonvulsant medications also are used as mood stabilizers. They were originally developed to treat seizures, but they were found to help control moods as well. One anticonvulsant commonly used as a mood stabilizer is valproic acid, also called divalproex sodium (Depakote). For some people, it may work better than lithium.6 Other anticonvulsants used as mood stabilizers are carbamazepine (Tegretol), lamotrigine (Lamictal) and oxcarbazepine (Trileptal).

Atypical antipsychotics

Atypical antipsychotic medications are sometimes used to treat symptoms of bipolar disorder. Often, antipsychotics are used along with other medications.

Antipsychotics used to treat people with bipolar disorder include:

  • Olanzapine (Zyprexa), which helps people with severe or psychotic depression, which often is accompanied by a break with reality, hallucinations, or delusions7
  • Aripiprazole (Abilify), which can be taken as a pill or as a shot
  • Risperidone (Risperdal)
  • Ziprasidone (Geodon)
  • Clozapine (Clorazil), which is often used for people who do not respond to lithium or anticonvulsants.8

Antidepressants

Antidepressants are sometimes used to treat symptoms of depression in bipolar disorder. Fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft) are a few that are used. However, people with bipolar disorder should not take an antidepressant on its own. Doing so can cause the person to rapidly switch from depression to mania, which can be dangerous.9 To prevent this problem, doctors give patients a mood stabilizer or an antipsychotic along with an antidepressant.

Research on whether antidepressants help people with bipolar depression is mixed. An NIMH-funded study found that antidepressants were no more effective than a placebo to help treat depression in people with bipolar disorder. The people were taking mood stabilizers along with the antidepressants. You can find out more about this study, called STEP-BD (Systematic Treatment Enhancement Program for Bipolar Disorder), here.10

What are the side effects?

Treatments for bipolar disorder have improved over the last 10 years. But everyone responds differently to medications. If you have any side effects, tell your doctor right away. He or she may change the dose or prescribe a different medication.

Different medications for treating bipolar disorder may cause different side effects. Some medications used for treating bipolar disorder have been linked to unique and serious symptoms, which are described below.

Lithium can cause several side effects, and some of them may become serious. They include:

  • Loss of coordination
  • Excessive thirst
  • Frequent urination
  • Blackouts
  • Seizures
  • Slurred speech
  • Fast, slow, irregular, or pounding heartbeat
  • Hallucinations (seeing things or hearing voices that do not exist)
  • Changes in vision
  • Itching, rash
  • Swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs.

If a person with bipolar disorder is being treated with lithium, he or she should visit the doctor regularly to check the levels of lithium in the blood, and make sure the kidneys and the thyroid are working normally.

Some possible side effects linked with valproic acid/divalproex sodium include:

  • Changes in weight
  • Nausea
  • Stomach pain
  • Vomiting
  • Anorexia
  • Loss of appetite.

Valproic acid may cause damage to the liver or pancreas, so people taking it should see their doctors regularly.

Valproic acid may affect young girls and women in unique ways. Sometimes, valproic acid may increase testosterone (a male hormone) levels in teenage girls and lead to a condition called polycystic ovarian syndrome (PCOS).11,12 PCOS is a disease that can affect fertility and make the menstrual cycle become irregular, but symptoms tend to go away after valproic acid is stopped.13 It also may cause birth defects in women who are pregnant.

Lamotrigine can cause a rare but serious skin rash that needs to be treated in a hospital. In some cases, this rash can cause permanent disability or be life-threatening.

In addition, valproic acid, lamotrigine, carbamazepine, oxcarbazepine and other anticonvulsant medications (listed in the chart at the end of this document) have an FDA warning. The warning states that their use may increase the risk of suicidal thoughts and behaviors. People taking anticonvulsant medications for bipolar or other illnesses should be closely monitored for new or worsening symptoms of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior. People taking these medications should not make any changes without talking to their health care professional.

Other medications for bipolar disorder may also be linked with rare but serious side effects. Always talk with the doctor or pharmacist about any potential side effects before taking the medication.

For information on side effects of antipsychotics, see the section on medications for treating schizophrenia.

For information on side effects and FDA warnings of antidepressants, see the section onmedications for treating depression.

How should medications for bipolar disorder be taken?

Medications should be taken as directed by a doctor. Sometimes a person's treatment plan needs to be changed. When changes in medicine are needed, the doctor will guide the change. A person should never stop taking a medication without asking a doctor for help.

There is no cure for bipolar disorder, but treatment works for many people. Treatment works best when it is continuous, rather than on and off. However, mood changes can happen even when there are no breaks in treatment. Patients should be open with their doctors about treatment. Talking about how treatment is working can help it be more effective.

It may be helpful for people or their family members to keep a daily chart of mood symptoms, treatments, sleep patterns, and life events. This chart can help patients and doctors track the illness. Doctors can use the chart to treat the illness most effectively.

Because medications for bipolar disorder can have serious side effects, it is important for anyone taking them to see the doctor regularly to check for possibly dangerous changes in the body.

bipolar, bi polar, or by polar ?????

on Saturday, 26 January 2013.

Not Only Do Many People Not Understand Bipolar Disorder...

bipolar, bi polar, or by polar ?????

So we did a little research on what terms people were entering in Google to get information on bipolar disorder. In a certain period of time, here's the terms searched on Google:

bi polar = 1,830,000 searches

bipolar = 2,740,000 searches

by polar = 11,100,000

Wow! Seems the education hurdle around the disorder is WAY higher than we orignially thought!!

bStable in NAMI North Carolina 2013 Spring Clippings Newsletter

on Saturday, 25 May 2013. Posted in General

McGraw Systems Proud to Support NAMI

bStable in NAMI North Carolina 2013 Spring Clippings Newsletter

bStable Presented to Alzheimer's Association!!

on Thursday, 09 May 2013. Posted in General

bStable Presented to the Western North Carolina Alzheimer's Association Chapter's Caregiver Education Forum

bStable Presented to Alzheimer's Association!!

bStable Should Have Been Mentioned in Our Data, Ourselves - Discover Magazine 2011 Issue

on Friday, 02 August 2013. Posted in General

“Self-Tracking” enthusiasts collect 
data on every aspect of their lives. If digital navel-gazing goes mainstream, 
it could transform medicine.


bStable Should Have Been Mentioned in Our Data, Ourselves - Discover Magazine 2011 Issue

By Kate Greene|Thursday, December 08, 2011

 

Bob Evans has spent most of his life obsessing over how to track data. When the Google software engineer was a boy in Louisville, Kentucky, he collected star stickers to show that he had done his chores. In college, where he studied philosophy and classical guitar, Evans logged the hours he spent playing music. Later, as an engineer for a Silicon Valley software company, he defended his dog, Paco, against a neighbor’s noise complaints by logging barks on a spreadsheet (the numbers vindicated Paco, showing he was not the source of the public disturbance). For Evans, collecting data has always been a way to keep tabs on his habits, track his goals, and confirm or dispel hunches about his daily existence.

Last May, Evans reminisced about those early days in data collection as we sat in a large-windowed conference room in Building 47 of the Google campus, near San Jose, California. His personal fixation is shared by a growing number of self-trackers, a movement that is spreading far beyond data-obsessed engineers. Taking advantage of new wearable wireless devices that can measure things like sleep patterns, walking speeds, heart rates, and even calories consumed and expended, more and more people are signing up to download and analyze their personal data. Nearly 10 million such devices will be sold in North America in 2011, according to the market forecasting company ABI Research.

Most self-trackers are extreme fitness buffs or—like Evans—technology pioneers inherently interested in novel software applications. But Evans believes that personal data collecting could have stunning payoffs that go beyond just taking a better measure of everyday behavior. Already, some proponents claim personal benefits from logging their habits—eliminating foods that trigger migraines or upset stomachs, for instance, or saving certain tasks for their most productive time of day. Applied more broadly, data collected by self-trackers could help them find better treatments for diseases and even predict illness before symptoms become obvious.

Evans also sees the potential for individual citizens to pool nonmedical data collected through tracking experiments. Such data sets could have important social benefits. For instance, if members of a community tracked their feelings about safety in their neighborhood and shared their data regularly, crime trends could be detected earlier and addressed more effectively.

As Evans’s history with data collection shows, basic self-tracking is possible with nothing more than a pencil and paper. Still, people have been reluctant to sign on to an activity that has historically required inordinately high levels of self-curiosity and motivation. Now, with the wildfire spread of smartphones and tablet computers, that resistance could be melting away—and Evans plans to capitalize on the change. He has developed a tracking tool, conveniently contained in a mobile phone app, that he thinks can make self-tracking appealing to the masses.

Most self-tracking devices currently on the market measure only a few data points and have their own proprietary software and code limiting how users can analyze their own metrics. Evans’s app is different: It can be set up to track any kind of behavior or event and keeps data in one place, making it possible to analyze it all together. It is also designed to address another major objection to such detailed self-reporting, the fear that our personal data could too easily be leaked, stolen, or simply exposed to the public.

My visit to Google was a chance to understand Evans’s vision and to try out its practical application. I’m not a data obsessive by any means. If Evans could convert me, self-tracking just might be for real.

In 2009, while Evans was working for Google to help create new tools to increase programmers’ efficiency, he realized no one was working on the “soft science” side of the equation to help the programmers become more productive in their personal behavior. In his data-oriented way, he set out to understand everything that happens in a programmer’s work life. He wondered how attitudes toward food, distractions, and work environment—sampled throughout the day
—might affect creativity. If a programmer was stressed out or unhappy with a project, could a glance at her daily stats help set her right? Could immediate insight from a survey encourage her to make a change for the better? Evans had a hunch that by gathering the right data sets, he could help people improve their job performance in real time.

To make this process as simple as possible, Evans decided to collect the data through the smart cell phones that Google employees already kept close at hand. He set up an app so a programmer’s phone would chime or buzz a few times throughout the day at random times, as if a text message had arrived. When the employee clicked the message open, the app would ask her if she felt passionate and productive about her project. If not, it asked what she could do to change it.

In addition to gathering data about work habits, Evans set up another survey that asked programmers to outline their work goals. When the app checked in later, it listed those goals and asked which one the programmer was engaged in—the idea being that if a programmer had been distracted, a reminder of what she wanted to accomplish might improve her focus. “I thought it would be cool to build a platform that was not just for collecting data,” Evans says. “It could have the tools and interventions so people could do their own self-improvement.”

The survey was rolled out two years ago to a small number of programmers at the Google campus. Although Evans worried that the app would be too intrusive, he was heartened to see that most programmers continued to use it even after the pilot program officially ended. Since each programmer had different goals, measuring the overall effectiveness of the app was difficult, Evans says, but subjectively, he and his colleagues felt the simple act of observing their behavior through the app led them to change in ways that helped them meet their work goals.

Evans’s daily productivity surveys soon inspired him to create a broader, more flexible mobile platform for self-experimentation that he dubbed PACO—an acronym for Personal Analytics Companion, but also a tribute to the dog that helped inspire his data-tracking ideas. Now PACO is used by thousands of Google employees, and not just for productivity. The app is fully customizable, which means it can track any data point a user dreams up. Some Googlers employ it to log exercise or participation in volunteer programs. Evans tailored his version of PACO to monitor his work tasks and exercise and as a reminder to eat fewer sweets. A colleague uses it to track carbohydrate intake and weight fluctuations and to compare trends across PACO experiments. “I look at the information I track every couple of months and remind myself of the progress I’ve made, or where I need to change my behavior,” Evans says.

After hearing him describe all the ways PACO has subtly changed the lives of his colleagues, I was ready for my own plunge into the world of self-tracking.

Logging personal data is probably as old as writing itself, but some modern self-trackers trace its origin to that godfather of American ingenuity, Benjamin Franklin. He was interested in how well he adhered to his famous 13 virtues, including frugality, sincerity, and moderation. Each day for several years he noted the ones he’d violated in a book he kept especially for the purpose.

More recently, Gordon Bell, a computer pioneer and researcher at Microsoft, introduced the concept of “life logging.” From 1998 to 2007, Bell collected his emails and scanned documents, photographs, and even continuous audio and video recordings of his day-to-day life into a searchable online database—an attempt to create a digital record of every thought and experience he’d had for a decade.

Within the past three years, though, self-tracking has grown into a veritable grassroots movement, embodied by an organization called Quantified Self, a community of data-driven types founded in the San Francisco Bay Area by journalists Kevin Kelly and Gary Wolf. Most Quantified Selfers have technology backgrounds, or at the very least a penchant for numbers. They gather in online forums and at face-to-face events to talk about their self-experimental methods, analyses, and conclusions. How does coffee correlate with productivity? What physical activity leads to the best sleep? How does food affect bowel movements? Mood? Headaches? No detail, it seems, is too intimate or banal to share.

The current explosion in 
self-tracking would not be possible without the mass digitization of personal data. Websites for tracking, graphing, and sharing data about health, exercise, and diet—many of which are linked to phone apps—are on the rise. RunKeeper, a popular data collection app for runners, reports 6 million users, up from 2 million in November 2010. The new small, affordable sensors, like the $100 Fitbit, can wirelessly log all sorts of human metrics: brainwave patterns during sleep, heart rates during exercise, leg power exerted on bike rides, number of steps taken, places visited, sounds heard. And a number of these sensors, such as microphones, GPS locators, and accelerometers, come inside smartphones, making some types of tracking effortless. Research firm eMarketer projects that by the end of 2012, 84.4 million people will use smartphones in the United States, up from 40.4 million in 2009.

2011 study by Pew Internet, a project at the Pew Research Center that investigates the impact of the Internet on American society, estimates that 27 percent 
of Internet users have kept track of their weight, diet, or exercise or monitored health indicators or symptoms online. Still, the Pew report also hints at a limitation inherent in the current self-tracking paradigm. It is still done mainly by conscientious people who are highly motivated to collect specific types of data about specific cases. Of the adults surveyed who own a cell phone, only 9 percent have mobile apps for tracking or managing their health.

“It’s still a relatively new idea that phones are windows into your behavior,” says computer scientist Alex Pentland, director of the Human Dynamics Laboratory at MIT. Most people, he adds, think that “health is the responsibility of your doctor, not you.” But self-tracking tools that give both patient and physician a snapshot of symptoms and lifestyle could become increasingly important to personal health.

Health is exactly what was on the mind of Alberto Savoia, a Google software engineer who supervises Evans, when he joined us in the conference room to discuss which PACO experiments had worked best for his team.

Savoia himself had created an experiment to track the effects of his allergy shots. He’d never had allergies until he moved to America from Italy. “I made fun of Americans,” he says, for sneezing at everything from cats to dust. “But lo and behold, I started to sniffle.” He suspected that his shots were helping, but as an engineer, Savoia knew to be skeptical of his own perceptions. He wanted quantitative proof. “Our brains construct fabulous stories,” he says. The daily reports he logged into PACO indicated that his shots for cat dander and pollen were working well: His symptoms were less severe and less frequent than they had been before the shots.

During the same test period, Evans created an experiment called Food Rules, based on the book of that name by Michael Pollan, a journalist who advocates eating simply and avoiding processed food. After each meal, PACO would ask: Did you eat real food? Was it mostly plants? Evans found that the very act of responding to these questions made him more aware of his eating habits. He started choosing his food in the Google cafeteria more carefully, knowing he would have to answer for it after lunch. Within weeks he stopped running the experiment because every answer was “yes.”

I considered their examples. It occurred to me that I sometimes sneeze fairly aggressively after meals. When I was a teenager, I ribbed my mother for her after-dinner sneezes, but in my early twenties I started sneezing too, with no obvious connection to specific foods. My mother had a hunch that the trigger was sugar, but I had my doubts: Who ever heard of a sugar allergy? I never kept a food log to find the actual culprit, but the question seemed perfect for PACO. In just a couple of minutes, the Google engineers walked me through the steps of creating my own experiment, which I called Sneezy, to track the problem.

I constructed a handful of 
other experiments as well, including one I dubbed Good Morning, Sunshine! in which PACO was programmed to ask me how well I had slept and what I’d dreamed about; Flossy, in which PACO asked me if I had flossed the day before; and the self-explanatory Call Your Mother, 
which had PACO pestering me on Sunday evenings to see if I had talked to my mother lately—and if so, what we’d discussed.

I chose to keep these experiments private: No one else could sign up to use them, and my data would be stored, encrypted, on a PACO server. The issue of privacy looms large over discussions of personal data collection. “It’s your daily ebb and flow,” Evans says of PACO-
collected data. “That’s something you need to control.” As PACO is currently built, a user can keep everything private, or she can share data by joining an experiment created by someone else. The information is stored in the cloud, on servers rented from Google. But unlike search terms, data from PACO are not mined by the company for patterns.

Self-tracking tools will probably never catch on with the wider public unless people are confident that their data are safe. “The key is giving individuals more control over their data, yet the flexibility to share it when they need to,” says MIT’s Pentland. To do this, he suggests, data should be protected by a “trust network” that is not a company or government agency. People might then establish their own personal data vaults for which they define the rules of sharing.

Pentland participates in a group called id3, which brings together government officials, academics, and industry representatives to establish guidelines for such networks. He expects the details to be worked out within the next two years. The stakes are high. If secure methods for sharing data anonymously can be developed, it won’t be just individuals taking advantage of the information they gather through self-tracking. Society as a whole could benefit.

in 2009 Matt Killingsworth, a psychology doctoral student at Harvard University, put a call out for people to join a study he called Track Your Happiness. An iPhone app queried participants—ranging in age from 18 to 88, living in 83 countries, and working in 86 job categories—throughout the day about their state of mind, their current activity, and their environment, among other things. At the end of the study, participants were given a happiness report, with graphs illustrating how happy they were and the activities and environment that affected their mood.

In 2010 Killingsworth analyzed responses from more than 2,200 people to see if what they were thinking about affected their happiness. The most striking result was that overall, people’s minds were wandering in almost half the survey responses, 
and people were less happy when their minds were wandering than when they were not. The findings were unexpected because previous studies, done with small numbers of people in the lab, concluded that people’s minds wander less often.

“The project illustrates that the promise and ability to track things in real time on a mobile phone in the course of your daily life is incredibly powerful,” Killingsworth says. Most previous studies would have been limited to questions asking a small number of people, after the fact, how they had felt at a certain time. Using mobile phones for this sort of study is “incredibly exciting,” Killings­worth says. “It allows us to collect more accurate data from many thousands of people.”

In the same vein as the health-oriented PACO experiments, Ian Eslick, a Ph.D. candidate in the New Media Medicine group at MIT’s Media Lab, is helping online patient communities convert anecdotes about treatments, such as how certain diets affect symptoms, into structured self-experiments. He is building an automated recommendation system that can suggest experiments to people based on their previous symptoms and responses to interventions.

For instance, no studies have uncovered a solid connection between diet and the symptoms of psoriasis, an inflammatory skin condition from which Eslick suffers. Some people find that cutting out sugar alleviates symptoms, while others 
do not. Eslick hopes that by collecting information on people’s self-experiments over a long period of time, he’ll have enough useful data to warrant the deployment of a traditional clinical trial to investigate the most successful interventions for psoriasis. “It’s a very different model than traditional medical research,” Eslick says. “Trials are expensive and hard to administer. They’re short. They run once and have to get your answer.” Self-experimentation, on the other hand, has the luxury of time. Experiments can run longer and produce more data because they are cheap to administer.

Customizable data collection systems like PACO make it easy to run those experiments, Eslick says. “PACO is cool not so much because it does data collection, but because it’s trying to make it easier to collect just the data you want, and just the stuff that’s relevant.”

Today’s smartphones can collect data such as location, speech patterns, and motion without any active input from the user. This sort of passive sensing of a person’s daily life makes them powerful tools for personal medical and psychological diagnostics.

Data sets of a person’s speech and movement could provide insight into conditions such as depression and Alzheimer’s disease. Some people’s speech and movements slow when they experience severe depression. If phone sensors could effectively measure change in speech or movement over time, then an app could suggest a doctor’s visit when a person’s state of mind declines.

A 2010 study by William Jarrold, a cognitive scientist at the University of California, Davis, suggests that an automated system that analyzes speech patterns on phone calls can potentially pick up on cognitive impairment and clinical depression or determine if someone is in the very early stages of Alzheimer’s. “Machine learning is getting better, the prevalence of cell phones and cloud computing is increasing, and we’re getting more data and doing more studies,” Jarrold says. “When data are collected over the course of years, they can provide relevant information about a person’s cognitive functions, diagnosing a decline before obvious symptoms arise.”

Data tracking could even help monitor infectious disease. Pentland has shown that certain patterns picked up by a person’s phone—such as a decrease in calls and text messages—correspond to onset of the common cold and influenza. If outfitted with software that can intervene when data analysis suggests the early stages of an illness, your next phone could help you figure out you’re sick before you are even aware of a problem.

My PACO experiments ran for about a month. Initially I wasn’t sure I’d like the distraction of a self-tracking app, let alone one that insisted I respond seven to nine times a day. Unexpectedly, I came to appreciate the way the app made me mindful of what I ate and how well I slept.

One thing I learned was that my mother was wrong: It wasn’t sugar that caused my sneezes. The Sneezy experiment told me that my morning meal was the main offender, especially when I drank coffee with cream. Beer also seemed to give me sniffles, though not every time. Thanks to PACO, I have narrowed down the possible culinary culprits. The experiment Happy Work Day was less surprising but also instructive. Twice a day it asked if I was working at my desk, and it often caught me doing something other than work (16 counts for not working to 25 counts for working). It made me more aware of the non-work tasks, like household chores, I spend time on during the day. I’ve since left many of these tasks for after conventional work hours.

The two experiments I hoped would influence my behavior were telling. According to Call Your Mother, I spoke with my mother only three times over the course of the experiment. I can’t say I have radically changed that behavior yet. But Flossy was a complete success. Having PACO ask me every day if I had flossed the day before seemed to do the psychological trick. I’m flossing every day. It’s a small miracle.

My thoroughly nonscientific experiences also suggest that PACO will have widespread appeal. When I explained it to my nontechnical friends, most instantly grasped the possibilities. A social worker imagined using the app to help find the triggers for negative feelings or actions in clients. A teacher wanted to use it to measure how exercise and food affect student engagement in class. A college professor I met thought he could use PACO to get a sense of how students are handling their workload.

It is still early days for the self-tracking movement, and future versions of applications like PACO will, no doubt, be much more powerful. Even if PACO itself doesn’t catch on, the idea of a program that allows people to adjust their behavior and monitor their well-being is too enticing to ignore; someone will make it work. The Bill and Melinda Gates Foundation and the mHealth Alliance, a group that includes representatives from the United Nations and the Rockefeller Foundation, are already encouraging the development of health-related phone apps. They are acting on the premise that a world in which it is easy for anyone anywhere to collect and securely share data with medical researchers could be a healthier place for all of us.

As any self-tracker knows, there is strength in numbers.

Celebrities with mental disorders

on Saturday, 15 June 2013. Posted in General

God love them for stepping forward and spreading awareness!!!

Celebrities with mental disorders

Child Mistreatment, Psychotropics, Sunshine Act, Dr. Peter Breggin

on Sunday, 17 February 2013. Posted in General

Child Mistreatment Certainly a Factor in Mental Illness, Meds Do Help, The Sunshine Act

Child Mistreatment, Psychotropics, Sunshine Act, Dr. Peter Breggin

I'm currently reading Toxic Psychiatry by Dr. Peter Breggin. Say what you want to say about him but one thing I can agree with him on is child mistreatment does play a major factor in why some develop mental illnesses. My humble opinion is there are genetic factors involved in mental illness as I've seen psychotropics help people diagnosed with various affective disorders. I think the key here is does the field of psychiatry really know what's going on? How a psychiatrist can only see a patient in the form of someone they throw meds at with little to no psychotherapy training is not very smart. Same goes with therapists and psychologists not factoring in psychotropics. Also, Dr. Breggin, I hope you take a holistic approach with patients and not just focus on talk therapy and why psychotropics are toxic.  

On a totally separate note, in reading more of Dr. Breggin's works, the thought crossed my mind that he must be very happy with the recent passage of the Physician Payments Sunshine Act which is a U.S. federal law stipulating that healthcare manufactures must aggregate and monitor total amount spent on individual healthcare professionals and organizations through payments, gifts, travel and other means to provide consumers with a transparent view into physician and industry interactions..       

Computer-Based Therapists

on Saturday, 26 January 2013. Posted in General

I can see him/her, I just can't smell him/her!

Computer-Based Therapists

If you go to liveperson.com, you can find hundreds of psychologists and therapists just waiting to provide Internet-based psychotherapy. People are working more and more from home and using their computers, Internet connections and phones to stay connected so why not do the same for psychotherapy? Anyone had experience with this? Do you miss your therapist's couch? Do you miss looking at your patients in "real life" and not via a computer monitor? Maybe as part of the web conference, the patients and psychologist/therapist/psychologist could have live, interactive bStable sessions to view how the patient has done since the last visit via the symptom monitoring the patient has recorded. Sounds like a convenient, efficient and practical way of doing things. Anyone had experience with this type of approach?

Confidentiality and the Family: 5 Guidelines for Better Outcomes

on Saturday, 20 April 2013. Posted in General

We've always promoted bStable's use with loved ones, patients and providers to provide a 360 degree loop

Confidentiality and the Family: 5 Guidelines for Better Outcomes

By Michael Ascher, MD, Justine Wittenauer, MD, Alison Heru, MD, and Ellen Berman, MD |April 11, 2013

 
Dr Ascher is MD a fourth-year Resident in the department of psychiatry and behavioral sciences at Beth Israel Medical Center, New York. Dr Wittenauer is a third-year Resident in the department of psychiatry and behavioral sciences at Emory University, Atlanta, Ga. Dr Heru is Associate Professor in the department of psychiatry at the University of Colorado, Denver. Dr Berman is Clinical Professor in the department of psychiatry at the University of Pennsylvania in Philadelphia.
 

Families  are an underutilized resource in psychiatric practice. Given the current practice of brief hospitalizations,  families are expected to provide more illness monitoring and in-home care. When  family members are included and welcomed as members of the treatment team,  patient care improves and the psychiatrist’s job is easier. Reaching out to  the families of patients can help psychiatrists generate clearer diagnostic  formulations, develop more effective treatment, and plan for emergencies.

What  should psychiatrists do when patients don’t give permission to contact their  families?

Many  psychiatrists erroneously believe that the sharing of information with others,  without the patient’s explicit consent, is prohibited by the Health Insurance  Portability and Accountability Act (HIPAA). HIPPA violations may have serious  consequences, so it is important to have a clear understanding of what the  HIPPA 45 CFR 164.510(b) rule entails as well as its intended use.1  The following information is extracted from the website of the US Department of  Health and Human Services and provides  guidance for health care providers. Here are some guidelines:

(1)  Health care information may be shared with relevant individuals present when  the patient has given prior approval, or simply does not object1

(2)  Asking a friend to be in the interview room provides the implicit right to  disclose information in their presence

(3)  Clinicians also have the authority within the Privacy Act to share information  based on their professional judgment, believing that there would be no  objection to its discussion. For example, a clinician may share information  about medication with those providing transportation from the hospital

(4)  If the patient is not present but has requested an individual to gather  information for him or her, or is incapacitated by an emergency, a physician  may once again use best judgment in sharing information. This may include a  proxy picking up of medications from the pharmacy or receiving other protected  information

(5)  Physicians should be aware of state laws within their region of practice that  may affect the use of the Privacy Act within scenarios of emergency or safety  concern

Using  these guidelines, family members (or friends) who accompany the patient can be  invited into the interview and the benefits of their inclusion explained. Most  evidence-based family interventions are psychoeducational, where illness  symptoms and treatments are explained and feelings and beliefs about the illness  are explored. When patients understand the goal of family intervention is  psychoeducational, they are more likely to agree.

Family  involvement is often misunderstood as being a hindrance to individuation, when  in fact family-oriented interventions can improve patient functioning, agency,  and autonomy. This is often the case when young adults are forced, because of  illness, to return home to live with their parents. The use of shared  decision-making may help the patients frame their long-term goals in line with  the goals of the family.2

Psychiatrists  can help the patient prepare for the family meeting. With a clear agenda, the  patient will be less anxious and be more accepting of family members working  with them. Psychiatrists can proceed, using one of the most underutilized  evidence-based interventions in psychiatry—family psychoeducation.

References 1. US  Department of Health and Human Services. Does the HIPAA Privacy Rule permit a  doctor to discuss a patient’s health status, treatment, or payment arrangements  with the patient’s family and friends? http://www.hhs.gov/hipaafaq/notice/488.html. Accessed  April 8, 2013. 2. Swindell JS,  McGuire AL, Halpern SD. Beneficent persuasion: pechniques and ethical  guidelines to improve patients’ decisions. Ann Fam Med. 2010;8:260–264.

Depression Prevalence

on Saturday, 26 January 2013.

That's a lot of people!

Depression Prevalence

According to WebMD:

The CDC says that about 9% of Americans report they are depressed at least occasionally, and 3.4% suffer from major depression.

The 9% are people who reported to surveyors that they felt depressed to some degree in the two weeks prior to being questioned. That includes the 3.4% of adults who meet the CDC’s criteria for major depression.

The analysis, part of the CDC’s Morbidity and Mortality Weekly Report(MMWR) for Oct. 1, was based on a survey of 235,067 people aged 18 and older in 45 states, Washington, D.C., Puerto Rico, and the Virgin Islands.

According to the MMWR, estimates for current depression in states and territories in 2006-2008 ranged from a low of 4.8% in North Dakota to 14.8% in Mississippi. People in Kentucky, New Jersey, North Carolina, Pennsylvania, and South Dakota did not participate in either the 2006 or the 2008 survey.

From wiki.answers.com:

340 million people in the world suffer from depression and rising

1 in 4 women will suffer from depression

1 in 10 men will suffer from depression (this statistic is not absolutely correct because more women are apt to see their doctor for depression than men do.)

Depression strikes all races, rich and poor.


Read more: http://wiki.answers.com/Q/How_many_people_in_the_world_suffer_from_depression#ixzz2J6DEV02m

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