And by “one thing” I mean prescribing medication.

Aside from the cost of mental health care, one of the biggest patient complaints I’ve heard since beginning Mental Health Notes and becoming involved with NAMI is the way in which appointments with psychiatrists seem to go these days.

It’s become the norm for a patient to take a half or whole day off work to sit in a waiting room for an hour or more only to see a psychiatrist for a few minutes in order to discuss whether or not a particular medication is working, grab a new or adjusted prescription, and leave in time for another patient to take the seat before the butt warmth has had time to cool.

When did psychiatrists decide it was okay to cut their services in half? Why are psychiatrists now merely tending to “medication management” (i.e. doling out drugs and monitoring their success) and leaving the “dirty work” to psychologists, social workers, and other non-doctor mental health professionals?

Read on.

From the Reuters article Move over Freud: Psychiatrists embrace pill power:

The shift to briefer visits for medication management, reported in the Archives of General Psychiatry, appears to be linked to better psychiatric drugs and pressure from managed care companies, which offer richer financial incentives for brief office visits.

“Psychiatrists get more for three, 15-minute medication management visits than for one 45 minute psychotherapy visit,” said Dr. Ramin Mojtabai of Johns Hopkins University in Baltimore and formerly of Beth Israel Medical Center in New York, where he did the research.

Up for a nice greedy round of money-grubbing, anyone?

Dr. Mojtabai also states that treatment from psychologists and social workers is most likely “short-term cognitive behavioral therapy” rather than the “analysis psychiatrists have traditionally offered.”

Of course, not everyone has dollar signs in their eyes.

While Dr. Mojtabai admits seeing a psychiatrist strictly for medication management and a psychologist or social worker for actual therapy “might not be as efficient” (as what? having a psychiatrist who actually knows more about you than what dosage of Zoloft you’re currently taking? and didn’t he just say the treatment from psychologists and social workers was different from what we can get from the analysis of a psychiatrist?), Dr. Eric Plakun, leader of an American Psychiatric Association committee on psychotherapy, notes that a shift in focus from psychotherapy to the biology of mental illness accounts for some of our psychiatrists’ current unwillingness to do more than drag out the prescription pad.

Plakun said in a telephone interview it is not clear if patients are getting therapy from other providers, or not at all.

“Either way, I’m worried about our patients,” he said. “Patients need the best help we can give them.”

For Plakun, that means offering a range of services, including psychotherapy, and not just medication. “If all you have is a hammer, everything looks like a nail,” he said.

Yes, everything does indeed start to look like a nail. If the only skills today’s psychiatrists are coming out of school with (or are willing to use) are the skills to properly medicate someone, does that mean more people than actually necessary are being medicated?

What about you? How would you describe your trips to the psychiatrist’s couch office? How happy are you with the various members of your mental illness management team?

Image: SXC

Post from: Blisstree

Is Your Psychiatrist Only Good For One Thing?

Well, they’re not all new, per se, but they’re some of the mental health blogs I’ve been checking out lately.

Recovering One Day At A Time is written by maryruth, a seriously busy American woman (she’s a single mother of four, a homeschooler to her special needs son, a writer, a NAMI advocate, and she just started working on her Master’s in Psychology!) who wants to share her “walk through mental illness to recovery.”

I’m Listening is written by “Wandering Coyote,” a Canadian lady who’s managing borderline personality disorder, dysthymia, and major depressive disorder and who seeks to bust the stigma of mental illness.

Clinically Clueless is written by “Clueless,” another American woman who, for the past 20 years, has both worked in the mental health field and has been is psychotherapy. Clueless has been dealing with dsysthymia, borderline personality disorder, major depressive disorder, post-traumatic stress disorder, and an eating disorder, as well as self-injury and suicidal ideation.

One Bipolar Life is written by “Preciousrock,” a single mother who is managing bipolar disorder, attention deficit disorder (ADD), and obsessive-compulsive disorder (OCD), and who also runs OneBipolarLife.com.

Advocate Support Blog is a very thorough blog that covers mental health resources, interesting links, mental health news, and other information related to mental health. The writer, James Crosson, is also affiliated with Advocate Support Services, Inc.

PsyBlog is by no means new (I think it’s been around since 2004), but I just recently stumbled across it. Its owner, freelance writer Jeremy Dean, has various degrees in the mental health field and he keeps the site packed with mental health information.

Mental Health – Able Mart is a sort of Web site/blog duo, where you can find articles/blog posts about everything from managing stress as a caregiver to bipolar disorder.

I’ve added each of these blogs to the blogroll here at Mental Health Notes, and if you know of any others you think I should feature, feel free to drop me a line in the comments.

In the meantime, happy reading!

Image: SXC

Post from: Blisstree

Check Out These New Mental Health Blogs

This post is part of Celebrity Health Week at the b5media Health & Wellness Channel. For more information about Celebrity Health Week posts here at Mental Health Notes, visit Introducing Celebrity Health Week: Celebrities And Mental Illness.

Now that we’ve nodded in the direction of celebrities who have bipolar disorder, let’s take a look at the illness itself so you can better understand what these famous folks are going through.

Keep in mind that this post is just an overview and by no means meant to act as a substitute for medical professional advice.

I gathered information about bipolar disorder from the same three major sources from which I gathered information for the Tell Me More About Depression: Signs, Symptoms, And Treatments post: The National Alliance on Mental Illness and their section on Bipolar Disorder; the National Institute of Mental Health and their booklet about Bipolar Disorder; and the Depression and Bipolar Support Alliance and their section on Bipolar Disorder.

So, after reading this overview of bipolar disorder, I highly recommend checking out those Web sites for more detailed information.

Read on!

Quick Facts about Bipolar Disorder

Bipolar disorder is a mental illness that causes extreme shifts in a person’s mood, energy, and ability to function. (It’s interesting that NAMI is currently referring to bipolar disorder as “medical illness” and NIMH is referring to bipolar disorder as “brain disorder” – bipolar disorder is both, of course, but I’ll stick to the good ol’ fashioned mental illness for now.)

According to the NIMH, there can be as many as 5.7 million American adults (or 2.6 percent of the population) age 18 and older in any given year who have bipolar disorder. Bipolar disorder typically develops when a person is in their late teens or early 20s; however, the illness can develop at any age.

Signs and Symptoms of Bipolar Disorder

There are many signs and symptoms of bipolar disorder, but for simplicity purposes they can be broken up into two categories: symptoms of mania (the highs) and symptoms of depression (the lows).

When a person with bipolar disorder is experiencing mania, he or she may:

• Experience such euphoria that he or she actually feels high.
• Have little or no need for sleep, feel an increase in energy, and even an increase in productivity and creativity.
• Have racing thoughts, talk very fast, and be easily distracted.
• Exhibit an increased sexual drive.
• Have poor judgment; make bad decisions.
• Feel as if he or she is “on top of the world,” untouchable and unstoppable, and having special powers and abilities
• Engage in substance abuse.

According to the NIMH, “A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.”

When a person with bipolar disorder is experiencing depression, he or she may:

• Sleep and/or eat too much or too little.
• Feel extreme sadness, worthlessness, anxiety, hopelessness, guilt, helplessness, and pessimism.
• Experience a decrease in energy, desire, and interest in activities.
• Feel restless and/or irritable.
• Have trouble concentrating and making decisions.
• Experience physical pain.
• Suicidal thoughts or attempts.

According to the NIMH, “A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.”

Different Types of Bipolar Disorder

Bipolar disorder is not as cut and dry as the – ahem – media may lead you to believe. A person with bipolar disorder may have:

• Type 1 Bipolar Disorder, the most severe type of bipolar disorder when the mood swings are the most frequent and severe.
• Type 2 Bipolar Disorder, a less severe type of bipolar disorder that involves depression and hypomania more often than depression and mania.
• Cyclothymic Disorder, an even less severe type of bipolar disorder when the mood swings are quite mild.

Someone with bipolar disorder may experience:

• Hypomania, when the mania level is mild to moderate.
• Mixed states, when the mania and depression symptoms occur at the same time.
• Rapid cycling, when the episodes of mania and depression occur more frequently than the time frames given above.
• Psychosis, when the episodes of mania and depression are so severe they cause hallucinations and delusions.

See why it’s best to get a doctor’s advice? This stuff can get confusing!

Treatment Options for Bipolar Disorder

Treatment options for bipolar disorder almost always involve medications (such as lithium and anticonvulsants) and psychosocial treatments (such as psychotherapy, cognitive behavioral therapy, interpersonal and social rhythm therapy, and family therapy). A doctor may determine that electroconvulsive therapy (ECT) would be beneficial, and sometimes people with bipolar disorder opt for a more natural treatment option such as herbal and natural supplements.

Bipolar disorder is often present for a while before it’s diagnosed. If you think you suffer from bipolar disorder, contact your doctor. If you think someone you know suffers from bipolar disorder, point him or her in the direction of these resources and encourage him or her to contact a doctor. There is absolutely nothing shameful or embarrassing about dealing with mental illness, and there are effective treatment options available.

Post from: Blisstree

Tell Me More About Bipolar Disorder: Signs, Symptoms, And Treatments

Grab Drug Advertisements by the Pills: Part Five

We’ve determined that most medications featured in drug advertisements are both the priciest and the newest drugs on the market, which unfortunately means you could end up emptying your pockets just to experience some pretty serious, unknown side effects.

However, there is good news. In addition to asking your doctor about cheaper prescription medications that have been around longer (and have better understood side effects), you could also ask your doctor about any lifestyle changes and alternative remedies that may provide similar management benefits and symptom relief.

For example, did you know that each of the following has at some point in time been suggested for depression and/or bipolar disorder treatment?

• Changes in diet/nutrition and exercise.
• An increase in Omega-3 fatty acids (such as fish oil and flaxseed oil).
• Joining and regularly attending support group meetings.
• Psychotherapy.
• Phototherapy.
• Acupuncture.

And those are just the simpler approaches. Other treatments alternative to prescription medications include vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), cingulotomy, and electroconvulsive therapy (ECT). (Note that these procedures are quite a bit more…”involved,” for lack of a better word, and could actually be much pricier than even the newest prescription drugs; however, they are alternatives and the side effects are generally pretty well known.)

Now, don’t misunderstand me. I’m not suggesting that any of these alternatives are better than any particular medication, nor am I trying to represent myself as some kind of all-natural guru. I completely understand that there are cases in which people need prescription medication. Trust me. I’ve been there.

But I am suggesting that – if you aren’t keen on paying big bucks for a medication that may be harboring some unknown side effects – you ask your doctor about lifestyle changes and alternative remedies.

Have any of you tried making lifestyle changes and/or alternative remedies for treating mental illness? Share your story below!

Image source and owner.

Post from: Blisstree

Grab Drug Advertisements By The Pills: Lifestyle Changes And Alternative Remedies

Once you’ve been properly diagnosed with obsessive-compulsive disorder, there are three main categories of treatment and management options for you: psychotherapy, medications, and self-care.

Psychotherapy

The Mayo Clinic gives a great, thorough definition of psychotherapy.

In short, psychotherapy is effective for both children and adults, and the form of psychotherapy called “cognitive behavior therapy” is generally used for treating and managing OCD. If your doctor suggests cognitive behavior therapy, you may engage in activities designed to help you retrain your current routines and thought patterns in order to squash compulsive behaviors, i.e. make them no longer necessary.

Medications

Of course, you knew medication was going to be an OCD treatment and management option. Drugs that have been approved by the FDA (and are heavily of the antidepressant persuasion) are commonly prescribed to folks with OCD; however, some doctors also recommend other types of medications – even those that aren’t yet FDA-approved.

In the end, and as it always is with medications, it’s up to both you and your doctor to determine which medication – if any – is right for you. On a personal note, I noticed that my OCD symptoms dramatically decreased (if not outright disappeared) when I took antidepressants. I just didn’t seem to care as much anymore about the things – the obsessions – that caused my compulsive behavior. However, I didn’t seem to care as much about anything else, either, so…

Self-Care

Self-care is an important part of any mental health treatment and management plan. Without taking care of yourself, the chances of therapy and medication working – regardless of the combination – are slim.

Your doctor will undoubtedly discuss with you ways you can better take care of yourself and help managed your OCD. Below are a few suggestions to give you an idea:

• Stick with the treatment plan you and your doctor have developed. This includes properly taking your medications and keeping your doctor informed about their effectiveness and any side effects.
• Learn as much as you can about OCD. Knowledge is power, my friends. Getting an upper hand on the disorder helps you better recognize and manage your symptoms – not to mention falling prey to stigma and stereotypes.
• Surround your self with support. Family members, friends, and support groups are important to help you manage any mental illness. And, when it comes to your family members and friends, it really helps if they understand the disorder, so don’t be afraid to educate them.
• Don’t use drugs or alcohol as coping methods. They don’t work, period. Sure, they may make you forget your problems, but it’s temporary amnesia. Your problems won’t go away, and you’ll always end up remembering them. Sooner or later you’ll need more and more alcohol or drugs to get the same numbing effect and, before you know it, you’ll have an addiction to add on to your list of troubles. Just say no people!
• Finally, try not to isolate yourself. You may prefer to run solo, but honestly, being in the company of others every now and then – even if it’s just on the phone – really does help.

Have any of these OCD treatment and management options worked for you? Have any of them not? Share your stories in the comments, and stay tuned for information about complications that arise when OCD is left untreated and unmanaged.

Image credit: Dani Simmonds.

Post from: Blisstree

Treatment And Management Options For OCD