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April 22, 2007

The Struggles to Get Help for a Bipolar Son in College

The recent events at Virginia Tech have gotten many groups putting more of a look into the difficulty of getting good mental health treatments in the US. The issue of how difficult it is to get help for many people who suffer from bipolar disorder is covered in this recent NPR interview with the noted author Pete Early.

In the interview he mentions:

"the real tragedy here is why aren't people getting help. Fairfax County, again where Cho is from, it's the wealthiest county in Virginia. It's one of the wealthiest counties in the United States. There's a two-month wait to get mental health services, in Fairfax County, a six-month wait to get a case manager. You know, that's despicable."

NPR: "But how did they get to be that way? I mean, all over the country, there are these big buildings that used to be mental hospitals."

MR. EARLEY: "And they're all closing down. We have been closing down these huge asylums because they were horrible places, but mainly because of money. The state shut them down overnight with the institutionalization, as soon as the federal government said we'll start taking care of people through social security, through federal payment, people with mental illnesses.

And overnight there is no place for them to go. Where are they gone? They've gone to our jails and prisons. There are 300,000 people right now in jail and prisons with bipolar disorders, schizophrenia and major depression. Third, HMOs. Since 1997, two-thirds of HMOs are profit-driven. Psychiatric beds are not profitable, so they've done away with them."

You can listen to the entire interview with Pete at the following link:

Listen to the Full Story: Author Pete Earley talks about his struggles to get help for his son

Posted by szadmin at 6:45 PM | Comments (0)

April 14, 2007

Study Shows Intensive Psychotherapy Helps In Bipolar Disorder

In this second write-up we've done on the results from the largest federally funded bipolar study ever conducted the University of Colorado reports that patients who receive psychotherapy in addition to medication get better faster from bipolar disorder's debilitating depression and stay better longer.

Part of a $26.8 million effort, the study found that adding intensive psychotherapy to a bipolar patient's medication treatment made them one and a half times more likely to be clinically well during any month of the study year, compared with a group that didn't receive intensive therapy, according to CU-Boulder psychology Professor David Miklowitz, the principal author of the study.

"The take home message here is that psychotherapy is a vital part of the effort to stabilize episodes of depression in people suffering from bipolar disorder," Miklowitz said. "If you get regular intensive therapy, the outcome for depression is going to be better than if you just take medications and have a couple of case management sessions."

The results of the study were published recently in the April edition of the journal Archives of General Psychiatry.

Medication is the first line of defense against the disease, also called manic depression. It affects an estimated 5.7 million Americans, many of whom develop the disorder in their teens or as young adults.

While psychotherapy is routinely used to treat bipolar disorder, its effectiveness up until now has been unclear, according to Miklowitz. The seven-year study involved 293 people suffering from bipolar depression who were already taking medication. The participants, who were treated in 15 sites across the country, were randomly assigned to one of three types of standardized, intensive, nine-month psychotherapies, or to a control group that received a brief psychotherapy program that involved three sessions of education about the disorder.

The three types of intensive therapies included a family-focused therapy that involves participants' family members and focuses on family coping, communication and problem-solving; cognitive behavioral therapy that focuses on helping the patient understand and cope with distortions in thinking and activity; and interpersonal and social rhythm therapy that focuses on stabilizing daily and nightly routines and solving key relationship problems.

After one year, 64 percent of those in the intensive psychotherapy groups had recovered from the episode of depression that brought them into treatment, compared with 52 percent in the control group. Patients in intensive psychotherapy also recovered an average of 110 days faster than those in the control group. None of the three therapies appeared to be significantly more effective than the others, although rates of recovery from depression were highest among those in family-focused therapy, Miklowitz said.

While fully controlling the ups and downs of bipolar disorder is not possible, doctors can delay patients' relapses into debilitating periods of depression and manic behavior. Relapses of the disorder can split up marriages, cause job loss and even lead to suicide, according to Miklowitz.

"You need drugs like lithium as a first-line offense against depression, but then the question becomes 'What if the person is not responding right away?' " Miklowitz said. "That's when therapy may be the missing ingredient. We're not saying you should get therapy instead of medication. It's therapy on top of medication."

Getting the treatments into the community will be a challenging task. "There also has to be a consciousness among clinicians that bipolar people benefit most from learning skills to cope with the disorder, rather than just generic counseling," he said. "Teaching patients and family members how to immediately recognize and get treatment for emerging symptoms is essential."

Miklowitz' study was part of the Systematic Treatment Enhancement Program for Bipolar Disorder study funded by the National Institutes of Health's National Institute of Mental Health.

Researchers at CU-Boulder and the University of Colorado at Denver and Health Sciences Center were also involved in a paired study that found that treatment of bipolar patients with mood stabilizers in conjunction with an antidepressant did not provide any benefit and had similar outcomes to treatment with just a mood stabilizer and a placebo pill. That study was published online in the New England Journal of Medicine on March 28.

Source: University of Colorado, Boulder

Posted by szadmin at 10:31 AM | Comments (4)

April 12, 2007

Lithium Helps Bipolar Brain Grow Gray Matter

UCLA professors Carrie Bearden and Paul Thompson have demonstrated that lithium increases the amount of gray matter in the brains of patients suffering from bipolar disorder.

When the UCLA neuroimaging researchers compared the brains of bipolar patients on lithium with those of people without the disorder and those of bipolar patients not on lithium, they discovered that the volume of gray matter in the brains of those patients who were taking lithium was as much as 15 percent greater in areas that are critical for attention and controlling emotions. This discovery may explain why lithium is of value to people who suffer from bipolar disorder.

The research is published in the journal Biological Psychiatry.

Posted by szadmin at 12:01 AM | Comments (4)

April 11, 2007

TrueHope EmpowerPlus - and Compliants about Unproven Nutritional Supplements for Bipolar Disorder

At Pendulum.org we make efforts to write about all the important developments in the complementary treatments that are being proven as effective in helping treat bipolar disorder. We aren't concerned about what company sells the effective treatments - but we absolutely care that they are truly proven effective as indicated by duplicated and well designed research studies performed by independent organizations. We don't want to see anyone harmed by products or services, and we don't want to see our community members waste their money. We want the companies that sell any type of product (complementary therapies or medications) to be completely honest about the research, risks, negative side-effects of what they offer - and to not overstate their case.

The following news report video out of Canada demonstrates how some customers feel that they've been misled by a supplement manufacturer called TrueHope, the makers of Empowerplus nutritional supplement. There are no nutritional supplements that a consensus of experts judge as having been proven effective (by themselves) in treatment of any serious mental illness (such as bipolar disorder or depression). We encourage you to watch the video below to understand this important issue:

For consumers - its important that you understand that its a part of capitalism (which overall is good) that every company (whether they are selling nutritional products or medications) have a financial incentive to emphasize the evidence that supports their product (while glossing over the contrary evidence and side effect information - so you have to be very skeptical of any new therapy. Be careful of any simple solution to the complex problem of bipolar disorder- its likely to be wrong. Any new development is most likely to be a solution to just a part of the problem - and all therapies should be discussed with your doctor.

The message that everyone should take away is be skeptical of claims by companies, and "buyer beware". This is especially true in the age of the Internet - where you can never tell if the person in the chat room or on the discussion board is actually a company representative who is telling a glorified and boastful (but inaccurate) story about how they were cured by this new therapy. The only way to avoid being taken advantage of is to be skeptical and wait until a lot of evidence by university research teams have validated a product or service's efficacy in multiple studies with a significant number of people (over 30) in each study.

Posted by szadmin at 11:29 AM | Comments (2)

April 9, 2007

Childhood Bipolar Disorder Controversy

The New Yorker magazine has an interesting article on the current controversy on whether it's possible (or even valid) to diagnose bipolar disorder in children. In the article the journalist Jerome Groopman talks to many experts at the National Institute of Mental Health and elsewhere and comes up with some interesting information. We encourage you to read the entire article.

The article notes that at a

N.I.M.H. meeting, the psychiatrists argued about whether bipolar disorder actually existed in children and whether an accurate diagnosis could be made. Meanwhile, articles inspired by the Papoloses' book "The Bipolar Child" began cropping up in the media. Mentions Time magazine's 2002 cover story. The number of children under 13 who have been diagnosed with bipolar disorder has increased 600% in the past 10 years. Many doctors fear that the media has exaggerated its prevalence in children. The situation has similarities to the overdiagnosis of attention-deficit hyperactivity disorder (A.D.H.D.) in children. The consequences of a misdiagnosis of bipolar can be dire.

Dr. ”Steven Hyman has it right, in our opinion, when he states at the end of the article that “ It’s really important that we define the kids with bipolar disorder and treat them, but it’s also important that we not begin to diagnose kids with excess exuberance or moodiness as having the disease. We have to realize that we are risking treating children who could turn into obese diabetics with involuntary movements. There is something very real about the kids with devastating and disruptive symptoms, but the question is still the boundaries. You can do more harm than good if you treat the wrong kid.”

Read the article here: What’s Normal? - The difficulty of diagnosing bipolar disorder in children.

Some commentary on the story is available at Mind Hacks blog: New Yorker on child bipolar controversy

Posted by szadmin at 10:58 AM | Comments (4)

April 6, 2007

Intensive Psychotherapy More Effective For Treating Bipolar Depression

Patients taking medications to treat bipolar disorder are more likely to get well faster and stay well if they receive intensive psychotherapy, according to results from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), funded by the National Institutes of Health's (NIH) National Institute of Mental Health (NIMH). The results are published in the April 2007 issue of the Archives of General Psychiatry.

Bipolar disorder is a debilitating illness marked by severe mood swings between depression and mania that affects 2.6 percent of Americans in any given year. "We know that medication is an important component in the treatment of bipolar illness. These new results suggest that adding specific, targeted psychotherapy to medication may help give patients a better shot at lasting recovery," said NIH Director Dr. Elias A. Zerhouni.

"STEP-BD is helping us identify the best tools-both medications and psychosocial treatments-that patients and their clinicians can use to battle the symptoms of this illness," said NIMH Director Thomas R. Insel, M.D.

Psychotherapy is routinely employed as a means to treat bipolar illness in conjunction with medication, but the extent to which psychotherapy is effective has been unclear. In addition, most psychotherapeutic studies have been limited to a single site and compared only one type of treatment to routine care. Thus, in addition to examining the role of medication, STEP-BD set out to compare several types of psychotherapy and pinpoint the most effective treatments and treatment combinations.

With 293 participants, David Miklowitz, Ph.D., of the University of Colorado and colleagues set out to test the effectiveness of three types of standardized, intensive, nine-month-long psychotherapy compared to a control group that received a three-session, psychoeducational program called collaborative care. The intensive therapies were:

* family-focused therapy, which required the participation and input of patients' family members and focused on enhancing family coping, communication and problem-solving;

* cognitive behavioral therapy, which focused on helping the patient understand distortions in thinking and activity, and learn new ways of coping with the illness; and

* interpersonal and social rhythm therapy, which focused on helping the patient stabilize his or her daily routines and sleep/wake cycles, and solve key relationship problems.

All participants were already taking medication for their bipolar disorder, and most were also enrolled in a STEP-BD medication study reported in the New England Journal of Medicine online on March 28, 2007. The researchers compared patients' time to recovery and their stability over one year.

Over the course of the year, 64 percent of those in the intensive psychotherapy groups had become well, compared with 52 percent of those in collaborative care therapy. Patients in intensive psychotherapy also became well an average of 110 days faster than those in collaborative care. In addition, patients who received intensive psychotherapy were one and a half times more likely to be clinically well during any month out of the study year than those who received collaborative care. Discontinuation rates among the groups were similar-36 percent of those in the intensive programs discontinued and 31 percent of those in collaborative care discontinued. None of the three intensive psychotherapies appeared to be significantly more effective than the others, although rates of recovery were higher among those in family-focused therapy compared to the other groups.

"Intensive psychotherapy, when used as an adjunctive treatment to medication, can significantly enhance a person's chances for recovering from depression and staying healthy over the long term," said Dr. Miklowitz. "It should be considered a vital part of the effort to treat bipolar illness."

Source: Miklowitz D. et al. Psychosocial Treatments for Bipolar Depression. Archives of General Psychiatry. Apr 2007; 164.

The research was funded by The National Institute of Mental Health (NIMH). The NIMH mission is to reduce the burden of mental and behavioral disorders through research on mind, brain, and behavior. More information is available at the NIMH website, http://www.nimh.nih.gov/.

Posted by szadmin at 6:39 PM | Comments (2)