Tuesday, April 19, 2011
Wednesday, April 13, 2011
BP Magazine: Bipolar Depression: The Downside of Up
From the Fall 2010 issue of bp Magazine.
It is the manic phase of bipolar disorder that attracts—no, demands—attention. But those who have the illness, or love someone who does, know it is depression that most disrupts and devastates lives—and dominates the course of the illness.
“Few people understand [that] depression sucks the life out of you,” says C.A., 52, of Oregon. “Desires, self-esteem, motivation, self-worth—any of those qualities that keep you going in life—disappear.” Since her 2002 bipolar diagnosis, she has gone only 18 consecutive months without depression.
When P.S. of Halifax, Nova Scotia, is sad, she sometimes avoids bike riding with her seven-year-old daughter. The guilt she feels at withdrawing from her child only intensifies her depression.
“You look at the functional outcomes, such as the ability to work, family life, being an active participant in society—this is largely driven by depressive, rather than manic, symptoms,” notes Roger S. McIntyre, MD, associate professor of psychiatry and pharmacology at the University of Toronto, and head of the Mood Disorders Psychopharmacology Unit at the University Health Network in Toronto.
One reason depression is more debilitating than mania is that it lasts longer; another is that it occurs more frequently: According to a 2002 study by Lewis L. Judd and colleagues at the University of California at San Diego published in the Archives of General Psychiatry, people with bipolar I experience depression three times as often as mania. For bipolar II, the ratio of time spent in depression versus mania is a whopping 40:1.
Bipolar depression is also difficult to diagnose, and therefore to treat. Some studies suggest that as many as 50 percent of those with bipolar disorder are misdiagnosed with unipolar depression, according to Michael E. Thase, MD, professor of psychiatry at the University of Pennsylvania School of Medicine and author of several books on bipolar, depression and related topics.
It’s not surprising that misdiagnoses frequently occur. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), doesn’t distinguish between bipolar and unipolar depression. Rather, a bipolar diagnosis is made based upon whether the person has experienced mania or hypomania.
“Bipolar depression looks very similar to major depression, with no distinct features,” says McIntyre. “That being said, people with bipolar depression more often complain of symptoms that are atypical for unipolar depression, including increased eating, sleeping, and profound reduction in energy. Moreover, people with bipolar depression also frequently complain of seasonal worsening and ‘therapeutic misadventures’ with antidepressants—that is, the depression gets worse with antidepressant therapy.”
Because bipolar and unipolar depression can “look” so similar, psychiatrists must take care to get detailed family histories—and to ask patients if they have ever experienced symptoms of mania or hypomania, says Eric D. Caine, MD, chairman of psychiatry at the University of Rochester Medical Center and an international expert on suicide prevention. Otherwise, “the tendency is to treat it as if it’s unipolar depression, with antidepressants alone, which may serve as rocket fuel for a manic episode,” he adds.
HOW IT FEELS
How does one experience bipolar depression? That depends upon whom you ask. Many people undergo distinct periods of stability, mania, and depression. Yet other individuals can feel both depressed and manic at the same time—simultaneously feeling very sad and energized.
Holly A. Swartz, MD, associate professor of psychiatry at the University of Pittsburgh School of Medicine, says it is relatively rare for people to meet the DSM-IV criteria for a mixed state, which requires a major depressive episode and a manic episode nearly every day for at least one week. “However, individuals meeting diagnostic criteria for either a depressive episode or a manic episode often have a few subsyndromal symptoms of the opposite pole of the disorder that co-occur with their predominant mood episode,” Swartz says. “For example, someone will meet full criteria for a depressive episode but will also have racing thoughts.”
Rapid-cycling—as defined by the DSM-IV diagnostic criteria—is having at least four distinct episodes of major depression, mania or hypomania, or mixed symptoms within a 12-month period. But it is possible to experience more than one rapid-cycling episode a week, or “even within one day,” according to the National Institute of Mental Health.Tuesday, April 12, 2011
Win A Free Vacation!
WALK STAR AND TEAM CAPTAIN REWARD PROGRAM!
To help get you in gear for NAMIWalks NYC this year we now have an extra incentive!
In partnership with Sunrise Premiums, NAMI NYC-Metro will be rewarding the first 10 Walk Stars to reach Walk Star status and the first 15 Team Captains that lead their teams to raise $3,000 or more ONLINE in support of the 2011 NAMIWalks NYC by giving them a fully-transferable voucher good for a 3 Day, 2 Night, Vacation Get-away, at any one of the following locations:
ORLANDO * ATLANTIC CITY * BRANSON * FT. LAUDERDALE CAPE COD * LAS VEGAS * WILLIAMSBURG * HILTON HEAD * DAYTONA BEACH * LAKE TAHOE
BIG ISLAND OF HAWAII * MASSANUTTEN * SEDONA
Transportation, including airfare is not included in the voucher. You will be responsible for all transportation costs. This voucher is good for a year from the date of issue with a value of up to $400 and pays for the hotel (with complementary breakfast) at a destination of the winner's choice.
Team Captains and Walk Stars now you have an added incentive to reach your fundraising goal and lead a Successful Team. By doing so, You help NAMI NYC-Metro fund our education programs, reduce stigma, build awareness about mental health, and WIN A Post-Walk Getaway Vacation!
Tuesday, April 5, 2011
Meet Danielle Ledesma
This week, I'm excited to introduce you all to Danielle Ledesma. I asked her to come in for an interview after I read her personal story on her Walker Web page. Danielle and her family have been deeply impacted by mental illness. After losing her sister to suicide in 1999, Danielle has become dedicated to eradicating stigma and supporting NAMI to make mental health services readily available to everyone. Danielle opened up to me about her experience with NAMI and how it has helped her cope.
I lost my sister Angelica to suicide on January 25, 1999. I was living in New York at the time, but soon after moved down to Florida to be with my mom. We both went to a few different organizations for support and found NAMI to be the most grassroots and provide the most resources. When I came back to New York, I volunteered here at NAMI-NYC Metro and worked the Helpline for a little while. Then in the summer of 2006, I moved out to California to work on “The Tonight Show” and joined NAMI West Side LA. I loved that chapter and eventually I was asked to join the board.
When “The Tonight Show” ended, Danielle returned to her hometown of New York City and began walking in NAMIWalks NYC in 2010. I asked her what I ask every NAMIWalks NYC walker: Why do you walk?
I walk because with a huge group, we are getting the word about mental illness out and fighting stigma. A lot of people don’t seek help because they are ashamed and I want to show those people there is nothing to be ashamed of. I walk to raise money for this incredible organization and to get more people to join us in our fight. Most of all I walk to keep my sister’s memory alive, and I will do it every year.
Danielle is not just a walker; she has proven to be an incredible fundraiser, and this year she is well on her way to reaching Walk Star status! She has set a very specific fundraising goal of $1,978 to honor the year her sister was born, and to date she has raised $965. I was curious to know her fundraising strategies and if she’s doing anything different this year.
This year, I’ve been doing email blasts and I’m also posting information on my friends’ Facebook walls so their friends can see it. The other day I saw a friend’s friend comment on the wall post I made. It’s great because I’m able to expand into other people’s networks.
I asked Danielle what she would say to those who are having difficulty fundraising this year. She had so many great suggestions.
First, make your letter very personal but not too lengthy. Two to three paragraphs is enough. Ask those people who receive your letter to reach out to the people they know and ask those individuals to do the same. Almost like a chain letter. Also, you can create a memorial page on memory-of.com [a website that memorializes those who lost their lives to suicide]. On that site, you can ask people to honor your lost loved one by making a donation to NAMIWalks NYC and include the link to your fundraising page.
Thank you, Danielle, for sharing your story, and helping to break down the walls of stigma.
Friday, March 25, 2011
Why Do You Walk?
Tell us why you walk and we'll post you video to our NAMIWalks NYC Blog. Check out Jennifer Siciliano's video here.
Thanks Jennifer!
Thursday, March 24, 2011
Her Name Was Nancy
Her name was Nancy. She called one morning last week in desperation. Her son, who has schizophrenia, was being released from the hospital the next day. She had been in denial about his diagnosis, and didn't have a plan in place for his discharge. She felt totally alone.
A trained Helpline volunteer spoke with Nancy for 20 minutes. The volunteer connected her with several resources, including an organization that offers treatment, education and vocational services. She gave Nancy the name of the facilitator of NAMI's support group for family members of people with schizophrenia, who is available to anyone who calls the Helpline in distress. She then assembled a hand-picked set of materials and resources for Nancy's particular needs, and mailed her a package that day.
Early fundraising for NAMIWalks NYC puts your donors' dollars to work immediately, supporting people like Nancy who seek our help every day.
Share this story with your donors. Use it to send 10 emails today. Urge them to contribute to your fundraising goal.
As a thank-you, we're offering the special raffle below.
To date we have raised $96,568.95 - 28% of $350,000 goal.
THIS WEEK:
Take a chance and email those you may not think will donate to you. You'll be surprised! Think past employers, college professors, or your child's teachers.
Receive one raffle entry for every $100 you raise.
How many entries will you receive?
The winner will have the opportunity to take another chance and fly high over New York City at NY Trapeze School!
WE WILL ANNOUNCE THE WINNER ON APRIL 7.
Monday, March 14, 2011
NAMIWalks NYC Night of Comedy
Join us for NAMIWalks NYC Night of Comedy. An evening filled with laughter, fun and friends as we celebrate the Walk Stars and Team Captains of NAMIWalks NYC.
Comic Strip Live
1568 2nd Ave between 81st and 82nd Streets
New York, NY 10028-2676
Complimentary entry for Team Captains, Walk Stars plus a guest!
Surprise comics from film and TV!
Challenge:
Every Walk Star who reaches a $1000 by March 30 will be entered into a raffle to win an Apple iPad!
Receive an additional entry for every $100 over your goal and every team member you recruit!
RSVP to 212-684-3365 or walk@naminyc.org
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