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Posts Tagged ‘Bipolar Disorder’

October is National Depression and Mental Health Screening Month

Monday, October 22nd, 2012

Depression is a condition that most people think of as being “stuck” in a low mood of either sadness or grief. With colder weather and shorter daylight hours on the horizon, we all can begin to feel a little down.

According to the National Institute of Mental Health, depression strikes millions each year, often with debilitating consequences.

This psychological disorder is so common that it is sometimes referred to as the “common cold” of mental health, as nearly 10 percent of the population suffers from a depressive disorder at any given time.

We all get down or have sad periods in our lives from time to time that can last a period of days or weeks, but when it continues for an extended period that keeps you from leading a normal, active, productive life you may need to evaluate yourself, your feelings, and seek treatment.

There are several different types of depression:

  • Major depression is one of the most severe types. It is an episode of change in mood that lasts for weeks or months. It usually involves a low or irritable mood and/or loss of interest or pleasure in usual activities. A person may experience only one episode of major depressive disorder, but often there are repeated episodes over a lifetime.
  • Dysthymia, often called melancholy, is less severe than major depression, but usually goes on for a longer period, often several years. There are usually periods of normalcy between episodes of low mood and symptoms do not completely disrupt a person’s normal activities.
  • Bipolar disorder involves episodes of depression, usually severe, alternating with episodes of extreme elation called mania.
  • Seasonal depression, also known as SAD, seasonal affective disorder or the winter blues, is a type of depression that only occurs at certain times of the year, usually in winter when the number of daylight hours decreases. Although predictable, it can be severe.
  • Psychotic depression refers to the situation when depression and hallucinations, or delusions are experienced at the same time.

This may be the result of a depression that becomes so severe that it results in the individual losing touch with reality.

Symptoms of depression can vary for each individual and depends on the type of depression. Common symptoms can include:

  • Difficulty concentrating, remembering details, or making decisions.
  • Fatigue and decreased energy.
  • Feelings of guilt or worthlessness.
  • Feelings of hopelessness or pessimism.
  • Insomnia or excessive sleeping.
  • Irritability.
  • Restlessness.
  • Loss of interest in hobbies once pleasurable, including sex.
  • Overeating or loss of appetite.
  • Persistent aches or pains, headaches, cramps or digestive problems that do not ease with treatment.
  • Persistent sad, anxious or “empty” feelings.
  • Thoughts of suicide or suicide attempts.

The general consensus may be that depression is normal in the elderly, people who have health problems, or people who have had personal problems, setbacks or tragedies. But clinical depression is always abnormal and requires medical attention.

Life has its ups and downs. We all experience that roller coaster. And sometimes when we are down it is hard to bounce back.

The good news is that depression can be diagnosed and treated effectively in most people. The largest hurtle is to recognize the symptoms and seek appropriate treatment for yourself or a loved one.

Mental Illness in the Workplace

Wednesday, March 14th, 2012

The Centre for Addiction and Mental Health estimates that mental health conditions are responsible for approximately 30% of all disability claims and 70% of the associated plan costs.

Employers dealing with these costs—and the related lost productivity—are understandably focused on getting employees who are dealing with mental health issues back to work as quickly as possible, in a suitable state to fulfill their duties. Achieving this requires three crucial elements: early identification and diagnosis of mental health concerns; an effective treatment plan; and a return-to-work strategy that enables the employee to gradually ease back into work life.

Identification and diagnosis
According to research published in the Journal of American Medicine, an estimated 40% of mental health-related cases are misdiagnosed or underdiagnosed, resulting in incorrect or insufficient treatment. Further, more than 50% of cases do not receive treatment at all. This is disturbing when you consider the impact that psychological illness can have on an individual’s ability to function, both in and out of the workplace. Clearly, the ability to identify a psychological illness early is paramount.

Those in supervisory roles who are in close contact with employees on a daily basis can come to understand their employees’ unique personality traits. With appropriate training, supervisors are ideally positioned to identify changes in employee behaviour that may signal the onset of mental health concerns. A properly trained supervisor can also effectively separate workplace issues such as harassment from those with psychological roots (e.g., a clinical mental illness, such as depression).

For example, according to the Canadian Mental Health Association, between 2% and 3% of Canadians may have seasonal affective disorder (SAD), though many may not realize it. A trained supervisor may recognize that an employee with a high number of absences in January and February—and who lacks concentration and misses deadlines during the winter months—may be affected by SAD. That employee could then be prompted to seek appropriate care, begin treatment and return to a fully functioning state.

Treatment plan
Treatment is another key component in effective psychological claims management. It is often left to the family physician to identify problems and initiate treatment while waiting for a formal appointment with a specialist. Too often, this means losing precious time through suboptimal prescriptions or inappropriate treatment. Employers should include wording in their benefits plan booklets to ensure that a specialist diagnosis is required for mental illness claims.

Back-to-work strategy
Effective diagnosis and treatment are essential to understanding an employee’s psychological and cognitive capabilities and how they align with the demands of a particular job. This understanding can help an employer to develop an effective transitional back-to-work plan. An individual who is recovering from an episode of depression, for example, may have a decreased ability to concentrate. A progressive, time-limited back-to-work plan—which could include short, specific tasks with written step-by-step instructions for each—and an environment with minimal disruptions can help the employee work his or her way back into a regular routine.

Mental health issues will likely remain a key concern for workplace productivity and claims management. However, the implementation of a pragmatic approach to identification, treatment and recovery can help to minimize the long-term effects and improve outcomes for employees and employers alike.

Light Therapy Can Ease Bipolar Depression For Some

Wednesday, December 29th, 2010

Bright light therapy can ease bipolar depression in some patients, according to a study published in the journal Bipolar Disorders. Researchers from the University of Pittsburgh School of Medicine’s Western Psychiatric Institute and Clinic studied nine women with bipolar disorder to examine the effects of light therapy in the morning or at midday on mood symptoms.

“There are limited effective treatments for the depressive phase of bipolar disorder,” said Dorothy Sit, M.D., assistant professor of psychiatry and the study’s first author. “While there are treatments that are effective for mania, the major problem is the depression, which can linger so long that it never really goes away.”

In this study, women with bipolar depression were given light boxes and instructed on how to use them at home. The women used the light boxes daily for two-week stretches of 15, 30 and 45 minutes. Some patients responded extremely well to the light therapy, and their symptoms of depression disappeared. The responders to light therapy stayed on the light therapy for an additional three or four months. Four patients received morning light, and five used their light boxes at midday. Participants also continued to take their prescribed medications throughout the study period.

“Three of the women who received morning light initially developed what we call a mixed state, with symptoms of depression and mania that occur all at once — racing thoughts, irritability, sleeplessness, anxiety and low mood,” said Dr. Sit. “But when another group began with midday light therapy, we found a much more stable response.”

Of the nine women treated, six achieved some degree of response, with several reaching full recovery from depressive symptoms. While most attained their best recovery with midday light, a few responded more fully to a final adjustment to morning light. “People with bipolar disorder are exquisitely sensitive to morning light, so this profound effect of morning treatment leading to mixed states is very informative and forces us to ask more questions,” said Dr. Sit. “Did we introduce light too early and disrupt circadian rhythms and sleep patterns?”

People with bipolar disorder are known to be sensitive to changes in outdoor ambient light and to seasonal changes. Researchers are asking whether the risk of suicide in patients with bipolar disorder could be linked to changes in light exposure.

“In our study, 44 percent of patients were full responders, and 22 percent were partial responders,” Dr. Sit and her colleagues write. “Light therapy, therefore, is an attractive and possibly effective augmentation strategy to improve the likelihood of full-treatment response.”

Optimal response was observed with midday light therapy for 45 or 60 minutes daily, noted Dr. Sit.

Other study authors are Katherine L. Wisner, M.D., Barbara H. Hanusa, Ph.D., and Stacy D. Stull, M.S., all of the Women’s Behavioral HealthCARE program at Western Psychiatric Institute and Clinic; and Michael Terman, Ph.D., Columbia University. Article: doi/full/10.1111/j.1399-5618.2007.00451.x

Researchers report funding from the Stanley Foundation, the University of Pittsburgh School of Medicine, National Institute of Mental Health, U.S. Department of Health and Human Services, Pfizer Inc., GlaxoSmithKline and the National Institute of Neurological Disorders and Stroke.

Universities and colleges ease final exam stress with innovative programs

Wednesday, December 15th, 2010

College students still pull all-nighters and ingest prodigious amounts of caffeine during finals week, but they can also choose creative programs to help ease the stress of exams.

John Carroll University students sip hot chocolate and roast s’mores over a fire pit outside Grasselli Library the night before exams begin. Earlier that evening, a “blessing of the brains” will occur at a Mass.

Final exams at many of Ohio’s public and private universities are given over the next two weeks. A mix of activities, including games, crafts and music, are offered by student affairs staff, while those in counseling and wellness centers provide stress- and anxiety-reducing advice and programs, including meditation and petting dogs provided by the college.

The goal is to get students to relax and to keep their lives balanced.

“During finals you can feel the stress — it becomes kind of palpable,” said Lori Morgan Flood, an assistant dean and director of the Center for Leadership in Health Promotion at Oberlin.

There has been an increasing emphasis on wellness over the last five years, said Flood, who has been at the college 13 years.

“I am not sure if it is that the students are more able to acknowledge their stress level and ask for help or the nature of the college experience,” she said. “Students really take their education seriously and get really driven and forget to sleep, eat well and hydrate. We help them remember what is important.”

Melanie Scanlon, assistant director for student activities and leadership at Case Western Reserve University, agreed.

“We realize finals can be a stressful time,” Scanlon said. “We want to make sure students are mentally healthy and take time for breaks and to eat. They need to take care of themselves.”

Kelsey Gilbert, 20, an education, French and international studies major from The Dalles, Ore., decorated a picture frame with fellow juniors Sarah Lukowski and Andrew Jorgensen, both 20.

“Some people bring their work with them and get food and then study,” she said. “It’s nice to just get out of the library and relax a little.”

Sophomore Molly Francis, 19, sat down with friends to eat. A mechanical engineering major facing five finals, she was feeling the stress.

“I kind of want to claw my eyes out,” she said. “It’s really crazy, but I still wanted to come to this because it’s a fun thing to do that doesn’t involve finals.”

CWRU, like many universities, offers breakfast at midnight in dining halls, where faculty, staff and administrators serve food from 11 p.m. to 1 a.m. the night before exams begin.

Some programs became so popular during finals week that they now are offered year-round.

For instance, the art therapy program at Oberlin allows students to release stress by painting, drawing and doing other art projects. Students at Baldwin-Wallace College use the Mind Spa, which includes relaxation CDs, a chair massage and a light box to treat Seasonal Affective Disorder.

Universities are always seeking new activities for finals week, officials said.

Oberlin’s five-minute dance marathon was introduced this fall during midterms, Flood said. Since most students study in the library, there are music breaks at 5 and 11 p.m.

When a song, chosen by students in an online poll, played from an iPod plugged into speakers, more than 100 students there stood up and danced, she said.

Light Therapy for Bipolar Disorders

Thursday, July 8th, 2010

Bright light therapy can ease bipolar depression in some patients, according to a study published in the journal Bipolar Disorders. Researchers from the University of Pittsburgh School of Medicine’s Western Psychiatric Institute and Clinic studied nine women with bipolar disorder to examine the effects of light therapy in the morning or at midday on mood symptoms.

“There are limited effective treatments for the depressive phase of bipolar disorder,” said Dorothy Sit, M.D., assistant professor of psychiatry and the study’s first author. “While there are treatments that are effective for mania, the major problem is the depression, which can linger so long that it never really goes away.”

In this study, women with bipolar depression were given light boxes and instructed on how to use them at home. The women used the light boxes daily for two-week stretches of 15, 30 and 45 minutes. Some patients responded extremely well to the light therapy, and their symptoms of depression disappeared. The responders to light therapy stayed on the light therapy for an additional three or four months. Four patients received morning light, and five used their light boxes at midday. Participants also continued to take their prescribed medications throughout the study period.

“Three of the women who received morning light initially developed what we call a mixed state, with symptoms of depression and mania that occur all at once — racing thoughts, irritability, sleeplessness, anxiety and low mood,” said Dr. Sit. “But when another group began with midday light therapy, we found a much more stable response.”

Of the nine women treated, six achieved some degree of response, with several reaching full recovery from depressive symptoms. While most attained their best recovery with midday light, a few responded more fully to a final adjustment to morning light. “People with bipolar disorder are exquisitely sensitive to morning light, so this profound effect of morning treatment leading to mixed states is very informative and forces us to ask more questions,” said Dr. Sit. “Did we introduce light too early and disrupt circadian rhythms and sleep patterns?”

People with bipolar disorder are known to be sensitive to changes in outdoor ambient light and to seasonal changes. Researchers are asking whether the risk of suicide in patients with bipolar disorder could be linked to changes in light exposure.

“In our study, 44 percent of patients were full responders, and 22 percent were partial responders,” Dr. Sit and her colleagues write. “Light therapy, therefore, is an attractive and possibly effective augmentation strategy to improve the likelihood of full-treatment response.”

Optimal response was observed with midday light therapy for 45 or 60 minutes daily, noted Dr. Sit.

Other study authors are Katherine L. Wisner, M.D., Barbara H. Hanusa, Ph.D., and Stacy D. Stull, M.S., all of the Women’s Behavioral HealthCARE program at Western Psychiatric Institute and Clinic; and Michael Terman, Ph.D., Columbia University. Article: doi/full/10.1111/j.1399-5618.2007.00451.x

Researchers report funding from the Stanley Foundation, the University of Pittsburgh School of Medicine, National Institute of Mental Health, U.S. Department of Health and Human Services, Pfizer Inc., GlaxoSmithKline and the National Institute of Neurological Disorders and Stroke.


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