October 29, 2009
Government program supports Employment for people with bipolar disorder and other disabilities
During the NAMI 2009 conference we met with representatives of the Social Security Adminstration's Ticket to Work program which provides financial incentives for small businesses to employ people with disabilities. This program has been retooled recently with the objective of making it easier and more lucrative for businesses to hire people who suffer from bipolar disorder, depression and other Mental Illnesses.
Earlier today, we received a note from this program with a schedule of events in 15 states during November. For more information or to sign up for one of these program you can access Ticket to Work.
If you own a small business or are in a situation where you might qualify to work in a small business, you might review this program. The program administrators are actively working to add new businesses and get more people with disabilities back to work.
Also available is a Ticket to Work powerpoint document NAMI Workshop Slides.ppt that offers a more comphrensive overview of this progam. Be forewarned, this is 65 slide document.
October 28, 2009
Children taking meds for bipolar disorder can effect rapid weight gain
Children taking psychiatric medications for bipolar disorder and other mental illnesses can experience rapid weight gain according to a new study published in the Oct. 28 The Journal of the American Medicine Association. The findings also link some of these drugs to metabolic changes such as elevated levels of cholesterol and triglycerides.
The Study monitored 272 children from the Queens, NY area, ages 4-19 (with an average age of 14), over a six year period (2001-2007); these children were receiving atypical antipsychotics such as Abilify, Risperdal, Seroquel, and Zyprexa for the first time. These medicines are considered 2nd generation drugs which improve upon earlier first generation antipsychotics which had numerous unpleasant side effects for patients. It's important to note that while all four of the drugs studied are approved for use on adults by the FDA, only Abilify and Risperdal are currently approved for pediatric use.
While weight gain has long been considered a common side effect for some of these drugs, today's study focuses on the impact of these drugs on young children and teenagers. The study shows weight gains of between 10-19 pounds over a three-month period. This study only reveals the short-term impact of taking these drugs on weight gain; the researchers intend to monitor these patients over a longer period of time.
This study confirms what many patients, doctors and researchers suspected: that taking these drugs can lead to weight gain in children. Parents should be fully aware of this potential side effect when their kids are diagnosed with bipolar disorder, depression etc. and treated with one of these drugs. Of course, many if not most doctors and parents will come to the conclusion that treating and controlling a child's bipolar disorder illness with one of these drugs outweighs the potential side effect of weight gain. That said, patients and their parents should be fully aware of the drugs' side effects.
For more information, review the accompanying JAMA Editorial regarding this study.
October 27, 2009
Review of Mood Tracking Software: MoodTracker.com
Our findings are drawn from conversations with the MoodTracker.com CEO (David Hale), current users of MoodTraker.com, and our independent review of MoodTracker.com. We plan to monitor this software, stay in touch with active users and provide subsequent updates. We use pseudonyms to ensure MoodTracker users' privacy.
What is MoodTracker.com?
MoodTracker.com is a web-based Mood Tracking system which helps people who suffer from bipolar depression or depression track relevant information & data associated with their illness. This information includes: establishing a daily mood chart; charting a patient's "Mood History;" establishing a patient's Medical History; building in Support Alerts which offer users email, text messages etc. to take medicine or some other action step; and recording caregiver information.
MoodTracker.com provides a web-based tool that is easy to use, requires little time for patients to set up, and is easily accessible for patients, family members or Doctors (if patients allow such access to their online accounts). MoodTracker.com also provides an online Forum area for patients to discuss questions about how to use MoodTracker.com;
What do users say about it?
We spoke with Jennifer, a MoodTracker.com user, about her experience with the online tracking system. Jennifer researched various mood tracking systems and choose MoodTracker.com. She considered it essential that the system be web-based; she liked the flexibility of having her account & data on a server which could be accessed from any online source. She views this system has a good way to share relevant information with her Doctor who could easily access her information in advance of their sessions and be "current" on various data points. She also feels the various pie charts and graphs offered a user friendly, helpful way to visualize her moods and relevant data. She also likes the ability to send alerts to herself for various action points including taking medicine. Lastly, she found the Forum section to be user friendly, helpful and relevant to her ongoing issues.
Software tool versus web-based system.
Readers may recall that the Founder/CEO of the bStable product (see Sept. 15 post), researched the software versus web-based issue and came down strongly in favor of building a software tool. David Hale came to the opposite conclusion and decided to build a web-based application. One of the key issues patients that can arise with a web-based system is the security of the data. David points out that MoodTracker.com does not require any personal ID information to create an account; of course, patients are free to use any name/password combination as well as any email address so their use of MoodTracker.com is quite secure.
What does MoodTracker.com cost?
There are two MoodTracker.com versions. The basic version, MoodTracker, is free. An enhanced version, MoodTracker Plus, costs $24.95 annually and includes:
Pie Charts: With Pie Charts you get a summary of your moods by percentage. This can be very helpful for evaluating your moods over time and getting a better feel for the effectiveness of your medications. You can see your pie charts summarized by month, quarter, or year. Each pie chart is also sub-categorized by medication history, and there are different pie charts for mood, sleep, anxiety, and irritability.
Exercise Tracking: You can easily set up any number of exercise records to create a customized exercise plan. Each record specifies the exercise, the date when you started it, and how frequently it's done.
Significant Event Tracking: If a significant event occurs that greatly affects your mood, you can mark it on your chart.
No Advertisements: When you login to your MoodTracker Plus+ account, you won't see any ads. Basic MoodTracker users will see Google Ads on MoodTracker.com
MoodTracker is a good web-based mood tracking tool. It is easy to use and enables users to track relevant data points on a daily basis. MoodTracker Plus offers some nice additional charting, avoids advertising and is inexpensive. All in all we think this is a good system for those who prefer a web-based system versus a software based solution. It's one of a few independent sites (i.e. not affiliated with a pharmaceutical firm) that caters specifically to patients with bipolar disorder. We will continue to monitor MoodTracker.com's progress.
October 26, 2009
College Survey: Bipolar Disorder and Depression on the rise
We recently posted a blog (Oct 19) about the increase in bipolar disorder and depression on college campuses. We cited an NPR Story on "Morning Edition" which highlighted actions that Stanford students are taking to educate other students about Mental Illness. We also cited a multi-decade study which surveyed college counseling professionals across the U.S. We've tracked down the survey, a compressive study which offers a look at the intensity and incidence of Mental Illness on colleges dating back to the early 1980s as well as a snapshot of the current state of counseling services on US colleges.
The survey includes 284 counseling centers from a broad range of colleges from small Liberal Arts colleges to large Universities including MIT, Duke, Cornell, Swarthmore, Rhode Island School of Design (RISD), the University of Texas (Austin), the University of Wisconsin (Madison) & the University of California (Davis). .
The survey offers an illuminating look at the current state of Mental Illness within US colleges and the availability or lack thereof of critical counseling and psychiatric services on campuses. A few highlights:
Scope of survey: 284 counseling centers from a broad sample of US colleges and Universities representing approx 3.4 million students.
9% of enrolled students sought counseling services during the past year; an additional 29.6% (almost one million) were seen by counselors in other contexts (workshops, orientations etc
Only 60% of schools offer psychiatric services on campus; the number of consultation hours per week per 1,000 students is 1.7
Almost one-third of directors believe that psychiatric consultation is woefully inadequate or non-existent on their campuses.
95% of directors report that the recent trend toward greater number of students with severe psychological problems continues to be true on their campuses
Center Directors report that 49% of their clients have severe psychological problems
26% of center clients (students) are on psychiatric medication. This figure is up from 20% in 2003, 17% in 2000, and 9% in 1994.
Why is there a dramatic increase in the incidence and intensity fo Mentall Illnesses on college campuses? This question is beyond the scope of this particular blog post; however, it's an important issue which should concern both students and counseling professionals on college campuses. Please feel free to respond to this blog and offer your own insight into or experience of Mental Illness on your college campus. This is an important issue and your input may be helpful to a fellow student in need of support and understanding.
October 21, 2009
Bring Change 2 Mind Launches today
A new high-profile organization, Bring Change 2 Mind, is being launched today through a series of public service announcements (PSAs). The PSAs address the stigma of Mental Illness and raise awareness of the prevalence of Mental Illness in the U.S.; they are directed by Ron Howard and feature Glenn Close.
Glenn Close is working in concert with several leading organizations to create Bring Change 2 Mind. For more information, see www.bringchange2mind.org. Ms. Close has a sister, Jessie, who suffers from bipolar disorder.
I must admit that I became a bit emotional when watching a few of the clips available at www.bringchange2mind.org/index.php/share-your-story It takes courage for people, like Jessie, to announce to the world that they suffer from bipolar disorder or other Mental Illnesses. However, it's this type of personal courage which will help educate people and chip away at the stigma attached to Illnesses such as bipolar disorder and depression that lingers in society today. By lending her celebrity status to this issue, and personalizing it through an intimate portrayal of her sister's battle with bipolar disorder, Ms. Close is creating a strong platform from which to educate people about Mental Illness. We at pendulum.org applaud her effort!
I believe the creation of Bring Change 2 Mind breaks new ground in the effort to educate people about Illnesses such as bipolar disorder, depression, and schizophrenia. The fact that Ron Howard and Glenn Close have paired up to create these PSAs insures that today's launch will be widely viewed. I encourage our readers to take a look at this campaign to experience its impact. Also, they are actively seeking people who want to share their story with a video clip on this new website.
Here's a partial list of the PSAs that will be part of today's launch:(please note that you need to scroll down the home pages of these websites to find the links to Glenn Close and/or Bring Change 2 Mind).
Please offer any comments or observations you may have about this new organization and campaign to raise awareness around Mental Illnesses such as bipolar disorder, depression and schizophrenia.
October 19, 2009
Dramatic increase in bipolar depression and depression in colleges
Following last Friday's post (Initial onset of Bipolar during College years), I heard an interesting NPR story today on "Morning Edition." The story focused on students at Stanford University who are taking the initiative to help educate other students about the prevalence of depression and bipolar depression in colleges across the United States. These students have created theatrical productions which touch upon social issues including the wide prevalence of mental illness on college campuses. Their intended audience: patients who may be reticent to accept or discuss their illness and people in dorm rooms who often unknowingly create hostile environments for students with depression or bipolar depression.
The story also touches upon on the dramatic increase in the severity and incidence of depression and bipolar depression among college students during the past ten years. According to surveys conducted by college counseling professionals across the U.S. during the past decade, there has been a 50% increase in the diagnosis of depression in college students across the U.S. Also, there are twice as many students taking psychiatric medicines compared to ten years ago. Stanford has responded to these facts and increased its campus based therapists from 10 - 16 during the past year.
The fact that these students are willing to raise awareness about mental illness is commendable. Despite the sea change in awareness of mental illnesses during the past 20 years, there remains a great deal of misunderstanding about depression and bipolar depression. For many people, particularly students, the very act of telling another person that you suffer from depression or bipolar depression requires courage and a willingness to reveal intimate personal information. Hats off to these Stanford students who are creating an empathetic and knowledgeable environment for students who suffer from bipolar depression and depression.
To access this story go to: www.npr.org/templates/story/story.php?storyId=113835383&sc=emaf
October 16, 2009
Initial onset of Bipolar during College years
This recent article http://healthnews.uc.edu/news/?/9324 caught my attention. It discusses the notion that depression in young college students can begin to manifest itself just weeks after school starts; at that time, the "the honeymoon period" is over and the ongoing stress of pursuing academic performance kicks in. Bipolar patients often experience a first depression during college. The first onset of a manic or depressed mood characteristic of bipolar disorder usually occurs during the late teens and early 20's; at least half of all cases start before age 25*
Attending college offers numerous triggers to set off a bad mood. The difference between typical students and those who may be bipolar, is how they handle the stress of academic and/or peer pressure which manifests itself during the college years. There is a big difference between "being down" because of the academic work load and going into a depressed mode which doesn't lift for a period of time. If a bipolar patient is experiencing a depressed mood for the first time, it is extremely difficult to diagnose. Many if not most students will simply write it off as a manifestation of college pressure.
However, if there are telltale signs of depression: undue pessimism, loss of pleasure, loss of appetite, altered sleep patterns, unusual irritability, suicidal thoughts etc. these are likely to indicate something more than a "bad mood."
In my own experience, I had a difficult semester mid-way through college which, in retrospect, was my first bout with depression. At the time, I lacked tools or knowledge to address the depressed mode. However, now, after numerous years of life experience including several significant bouts of mania and depression, I'm much better equipped to manage my bipolar condition.
If a student has several of the telltale signs of depression listed above, they ought to quickly arrange to see a mental health professional to assess how to treat the condition. It's also incumbent upon parents or siblings to listen carefully to a possible patient's change in mood. Often times, a close family member or friend will be able to spot a manic or depressed mood better than the prospective patient. As uncomfortable as it may be for a family member or friend to suggest the possibility of bipolar or unipolar depression, they are offering the gift of insight to their loved one.
That insight could very well save the patient's life. Depression and Bipolar Disorder are serious diagnoses but are entirely treatable. We life in an era where there is much more information available on these disorders and less stigma attached to them. Increasingly, students and the general public accept the following statement, "Bipolar Disorder or Unipolar disorder are illnesses, like diabetes, with which people are born. They do not represent a "weakness" or "lack of willpower" any more than diabetes, or Parkinson's or any other serious illness represents a patient's lack of will power."
*Cited from NIHM website: http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml#pub1
October 13, 2009
Researchers find impact of single gene on Bipolar Disorder - Question use of Lithium for Children
A new study suggests that a single gene, called GSK-3, controls the signals that determine how many neurons actually end up composing the brain. This has important implications for patients with neuropsychiatric illness, as links have recently been drawn between GSK-3 and schizophrenia, depression and bipolar disorder. In populating the growing brain, neural stem cells must strike a delicate balance between two key processes - proliferation, in which the cells multiply to provide plenty of starting materials - and differentiation, in which those materials evolve into functioning neurons.
If the stem cells proliferate too much, they could grow out of control and produce a tumor. If they proliferate too little, there may not be enough cells to become the billions of neurons of the brain. Researchers at the University of North Carolina at Chapel Hill School of Medicine have now found that this critical balance rests in large part on a single gene, called GSK-3. Their work was published online on Oct 4 in Nature Neuroscience.
Relationship between GSK-3 and Lithium
One of the genes associated with schizophrenia appears to use GSK-3 as an intermediary to exert its effects on nerve cells. In addition, lithium, a popular treatment for bipolar disorder, acts, in part, by shutting down GSK-3. "I don't believe anyone would have imagined that deleting GSK-3 would have such dramatic effects on neural stem cells," said senior study author William D. Snider, M.D., professor of neurology and cell and molecular physiology, and director of the UNC Neuroscience Center. "People will have to think carefully about whether giving a drug like lithium to children could have negative effects on the underlying structure of the nervous system."
The Study Methodology
In the study, Snider and his colleagues created a mouse model in which both forms of the GSK-3 gene - designated alpha and beta - had been deleted. They decided to go after GSK-3 - which stands for glycogen synthase kinase 3 - because it is one of the most studied kinases or signaling molecules in all of biology. The researchers used a "conditional knock-out" strategy to remove GSK-3 at a specific time in the development of the mouse embryo, when a type of cell called a radial progenitor cell had just been formed.
As the brain develops, neural stem cells evolve through three different stages -- neural epithelial cells, radial progenitor cells and intermediate neural precursors. The radial progenitor cells are especially important because they are thought to provide the majority of the neurons of the developing brain but also differentiate themselves to give rise to all the cellular elements of the brain. The researchers discovered that deleting GSK-3 during this second phase of development caused the radial progenitor cells to be locked in a constant state of proliferation.
"It was really quite striking," said Snider. "Without GSK-3, these neural stem cells just keep dividing and dividing and dividing. The entire developing brain fills up with these neural stem cells that never turn into mature neurons."
GSK-3 is known to coordinate signals for proliferation and differentiation within nerve cells through multiple "signaling pathways." Thus, the researchers looked to see what effect deleting the molecule had on some of these pathways. They found that every one of the pathways that they studied went awry.
October 2, 2009
Some Teens and Young Adults May Grow Out of Their Bipolar Disorder
University of Missouri researchers have found evidence that nearly half of those diagnosed between the ages of 18 and 25 may outgrow the disorder by the time they reach 30.
"Using two large nationally representative studies, we found that there was a strikingly high peak prevalence of bipolar disorders in emerging adulthood," said David Cicero, doctoral student in the Department of Psychological Sciences in the College of Arts and Science
David Cicero is a graduate student, who led a paper on treatment of bipolar disorder.
and lead author of the paper. "During the third decade of life, the prevalence of the disorder appears to resolve substantially, suggesting patients become less symptomatic and may have a greater chance of recovery."
By examining the results of two large national surveys, MU researchers found an "age gradient" in the prevalence of bipolar disorder, with part of the population appearing to outgrow the disorder. In the survey results, 5.5 to 6.2 percent of people between the ages of 18 and 24 suffer from bipolar disorder, but only about 3 percent of people older than 29 suffer from bipolar disorder.
"Young adults between the ages of 18 and 24 are going through significant life changes and social strain, which could influence both the onset and course of the disorder," said Kenneth J. Sher, Curators' Professor in the Department of Psychological Sciences and co-author of the study. "During this period of life, young adults are exploring new roles and relationships and begin to leave their parents' homes for school or work. By the mid 20s, adults have begun to adjust to these changes and begin to settle down and form committed relationships."
Researchers predict the prevalence of the disorder also could be affected by brain development, particularly the prefrontal cortex. The prefrontal cortex, the very front part of the brain, is thought to control perception, senses, personality and intelligence. In particular, it controls reactions to social situations, which can be a challenge for people with bipolar disorder.
"The maturing of the prefrontal cortex of the brain around 25 years of age could biologically explain the developmentally limited aspect of bipolar disorder," Cicero said. "Other researchers have found a similar pattern in young adults with alcohol or substance abuse disorders."
While some scholars suggest that the difference could be due to discounting factors such as early mortality, the sheer number of those who are recovering rules out this possibility, Sher said.
The study, "Are There Developmentally Limited Forms of Bipolar Disorder?" was published in the Journal of Abnormal Psychology. It was co-authored by Cicero, Sher and Amee Epler, a doctoral student in the Department of Psychological Sciences.