Sam's Last Stand: 2011

Saturday 9: Sam's Last Stand: 2011

1. Over all, how do you feel about what happened in your life in 2011? 
Ehh ... and you can quote me on that

2. Do you do New Year's resolutions? If so, what are they this year? 
 I resolved to finish everything I start, but I stopped my Project 365 photo thing a few months into the year, so I don't think I kept that resolution

3. In the past 24 hours, I have reconnected with 3 old friends that I've not spoken to in years. If you could reconnect with someone from your past who would it be, and why? 
My ex-husband, and by "reconnect" I mean kill

4. Do you have anything that you would have not done or done differently in 2011 as you look back?
I would've ate less fast-food if I could go back

5. Going back to my ex-friends that I reconnected with, one of them ended over a boyfriend. She called to apologize. Do you have someone that you fell out with you and wonder how they are? 
I don't really care about anyone I had a falling out with

6. If you had a chance to reconnect with an ex (say for coffee), who would it be, and why? 
See answer to #3

7. One of resolutions is about weight-loss. Have you ever struggled with your diet?
I think the answer to #4 answers that 

8. What do you think was the top news story of 2011?
I suppose it would be something with the Iraq war and it ending

9. What are your plans for (New Year's Eve) tonight?
Working, of course

Meth Users Much More Likely to Try Suicide

By HealthDay 

Drug users who inject themselves with methamphetamine are 80 percent more likely to attempt suicide than those abusing other drugs, new research reveals.

The magnified risk for meth users is probably rooted in a mixture of social, structural and neurobiological factors, say researchers from Columbia University's Mailman School of Public Health in New York City and the University of British Columbia in Vancouver, Canada.

"Compared to other injection drug users, it is possible that methamphetamine users are more isolated and have poorer social support systems," study author and Mailman postdoctoral fellow Brandon Marshall said in a Columbia news release.

Marshall and his colleagues report their findings in the December issue of Drug and Alcohol Dependence.

The team used material from interviews involving nearly 1,900 men and women that were conducted in the Vancouver area over seven years, from 2001 to 2008. The authors note that Vancouver's downtown eastside district is well known as a center for illegal drug use.

"This is one of North America's largest cohorts of injection drug users, and the research is among the first longitudinal studies to examine attempts of suicide by injection drug users," Marshall (who is also a research coordinator for the Urban Health Research Initiative in British Colombia) said in the release.

A little more than a third of the participants were women, and another third were of Aboriginal descent. All responded to questions regarding their drug use, treatment experience and risky behaviors with respect to HIV. All told, 8 percent were found to have previously attempted suicide.

The authors found that meth injection was linked to a greater risk for suicide attempts across the board. That is, even infrequent meth users bore an elevated risk for attempting suicide, while those who frequently injected meth faced the highest such risk.

"The high rate of attempted suicide observed in this study suggests that suicide prevention efforts should be an integral part of substance abuse treatment programs," Marshall said. "In addition, people who inject methamphetamine but are not in treatment would likely benefit from improved suicide risk assessment and other mental health support services within health care settings."

The study was funded by both the U.S. National Institutes of Health and the Canadian Institutes of Health Research.

Man Won't Let His Mental Illness Define Him

By HealthDay 

Loren Booda experienced his first psychotic break when he was 19 years old.

Then a sophomore studying physics at an Ivy League university, Booda had struggled with feelings of anxiety and depression for years. He said he'd self-medicated by drinking and smoking marijuana. But then he tried LSD, and all of the demons that had been gnawing at his soul for years burst forth and took over his life.

"The LSD basically brought out all of the symptoms of mental illness that I'd grown accustomed to," said Booda, now 52 and living in Arlington, Va.

He eventually was diagnosed with schizo-affective disorder, an illness that combines psychotic symptoms with mood disturbances.

During that first psychotic break, Booda said, he heard voices that weren't there and became increasingly paranoid. He also experienced his first brush with the stigma associated with mental illness when the school asked him to leave after doctors first diagnosed him as a paranoid schizophrenic, a diagnosis that others refined later in his life.

"Once I was diagnosed with paranoid schizophrenia, people like that supposedly do not study at an Ivy League school or live on campus or participate in the university," Booda said.

He ended up living a life apart. His parents had enough money that he didn't have to work, Booda said, so he spent most of his time working volunteer jobs. He got a bachelor's degree in physics from George Washington University, but he's never worked in that field.

"A lot of times I think a volunteer job can be ideal, in that people are able to overlook disabilities," he said.

He volunteered for an energy company, for the Boy Scouts and for Goodwill Industries. "Finally, for 17 years, I worked at a park and worked my way up to the point where I could operate the park and nature area," Booda said.

Booda said he tried to get paying jobs, but his diagnosis often got in the way. He remembers one boss, who ended up becoming a good friend, treating him as though he wasn't suitable for the job.

"I worked for him two to six weeks," Booda said. "I was paid at the end of that period, and he said to me, 'Loren, you work better when you're not paid.' What kind of comment is that? It was hurtful."

Booda now works as a call-taker at the National Alliance on Mental Illness (NAMI), where he started as a volunteer in 1995 and began being paid for his work in 2003. He receives treatment for his illness, which includes taking four different medications, he has a girlfriend and steady work and tends to look on the bright side when it comes to his condition.

"My illness has given me an opportunity to work in places I might not otherwise have," he said. "I've been with my girlfriend for about nine years. I have two new cats, and they're knocking everything over hither and yon."

"And my work with NAMI -- I relish it," Booda said. "It's like a sustenance. I am making a difference."

Eating Disorders Can Last Well Beyond Teen Years

By HealthDay

Eating disorders such as anorexia and bulimia are typically thought to be diseases of young women and men. But researchers are finding that the personal demons that drive a young person to an eating disorder may linger into adulthood.

More and more middle-aged and older people are coming forward to receive treatment for eating problems that began in their youth and have been reignited by adult stress or personal crises.

"Some had actual eating disorders" when they were younger, and "others had aspects of an eating disorder but were never fully treated," said Dr. Ed Tyson, an eating disorders specialist in Austin, Texas. "Then something happens later in life that stresses them to a point where the eating disorder becomes engaged."

The Renfrew Center, which operates a number of eating disorder clinics in the United States, has seen a 42 percent increase in middle-aged female clients since 2001, said Holly Grishkat, senior director of clinical operations for the center's northeast region.

Unhealthy eating patterns adopted in adolescence or teen years often continue into adulthood, according to a University of Minnesota study published in the Journal of the American Dietetic Association. The study, which followed 2,287 kids as they grew into young adults, found that more than half of the girls had unhealthy eating patterns that continued into their mid- to late 20s.

That was the case with Alison Smela, 49, who lives in the Chicago area. When she was 12, she was given a weight plan to follow over the summer because she was considered overweight. Smela said she went back to school thinner, and people noticed approvingly.

"I got all kinds of attention, and I liked that," she said. "I equated losing weight with gaining attention."

Controlling her eating also helped Smela feel better when things seemed too much to handle. "When life got tough, I always knew I could control the scale," she said.

But as she grew more successful and climbed the corporate ladder, her anorexia spiraled out of control. So did her problem with heavy drinking.

"The more pressure I was under, the more titles I had, I wasn't dealing with the pressures of the job and of life in a healthy manner," she said.

Tyson said that eating disorders can be very devastating to the bodies at middle-age, when osteoporosis, chemical imbalances and other health issues crop up more easily and have an even more lasting impact on health.

"Older bodies do not have the plasticity that younger bodies do," he explained. "They can't tolerate the stresses and risks."

When Smela turned 40, she said, she decided to receive treatment for her alcoholism. She's now nearly a decade sober. But her eating disorder remained untreated, even though she knew she had a problem.

"I presumed alcoholism was more acceptable to society at my age," she said. "Having an eating disorder wasn't."

That's not an uncommon perception for middle-aged people with an eating disorder, Tyson said.

"They feel more peculiar because they're older," he said. "They think this is something for younger people, not for them. There's some shame associated with it."

Diane Butrym, 50, of Schenectady, N.Y., said such concerns are justified but must be surmounted. When Butrym went to the Renfrew Center for treatment eight years ago, she said, she found herself uncomfortable in the presence of the younger women struggling with the same problem she had.

"One of the parents said, 'Aren't you a little too old to be going through this?'" recalled Butrym, who still struggles with her eating disorder. "That was very embarrassing for me. It was really hard to overcome that."

The specific problems faced by middle-aged people with eating disorders prompted the Renfrew Center to create a separate treatment program specifically tailored to their needs, Grishkat said.

"The older women tend to mother the younger women and take care of the younger women in the group rather than taking care of themselves," Grishkat said. "The other thing we've noticed, the older women have a tendency to sit back and not say anything because they're ashamed. They feel like they should be the role models for the younger women."

What drives someone in midlife to seek help for an eating disorder varies. For Smela, who was 46 at the time she first went to the Renfrew Center, it was her reflection, she said.

"The summer before I went for treatment, I started catching glimpses of myself in a mirror or reflection, and I was scared," she said. "I saw my body as a whole, and it scared me."

But no matter what age they are, people who feel they have an eating disorder need to seek help, Grishkat and Tyson said. Talk to a doctor, contact the Renfrew Center or similar facility or reach out to the National Eating Disorders Association, the two experts suggested.

Treatment is particularly vital if the person has children, even if treatment will temporarily take them away from their responsibilities at home, Tyson said.

"Having an eating disorder makes their children have a 12- to 15-fold greater risk of having an eating disorder," he said. "They need to do the work and get better, or their children could be at risk."

Stigma of Mental Illness Won't Fade

By HealthDay 

People with a mental illness struggle with symptoms ranging from crushing depression and crippling anxiety to powerful delusions and hallucinations that force them to actively sort out the real from the imagined.

And if that weren't enough, they also have to deal with the way the rest of the world perceives their inner struggle.

Stigma associated with mental illness remains widespread in U.S. society, despite some progress made in demystifying these medical conditions, said Michael J. Fitzpatrick, executive director of the National Alliance on Mental Illness (NAMI).

"It's pervasive, but it's nuanced, too," Fitzpatrick said. "Most Americans understand that mental illnesses are treatable illnesses. I think people basically understand depression. Depression is talked about in the media and is considered a treatable disease. But when you reach psychosis and schizophrenia, there's still a lot of misunderstanding and fear."

As a result, people with a mental illness often feel isolated, afraid and rejected by society -- a stigma that causes many people to go without the treatment they need, said Dr. Garianne Gunter, an adult and child psychiatrist with the South Carolina Department of Mental Health.

An estimated one in five people will suffer from a mental or neurological disorder at some point in their lives, according to NAMI. Yet two-thirds of people with a known mental disorder never seek treatment.

"A lot of times, people won't seek help for mental illness because of the stigma," Gunter said. "They won't get help until they're near suicide or they are suffering from very severe symptoms."

The U.S. military has recognized this as a problem for troops returning from active duty in a war zone, Gunter said. Soldiers with post-traumatic stress disorder or another form of mental injury, she said, won't seek help because they are worried it could end their careers.

Both the U.S. and British armed forces have launched efforts to reduce the stigma attached to mental illness, urging soldiers to come forward for treatment. The "Real Warriors Campaign" in the United States and the "Don't Bottle It Up" initiative in the United Kingdom aim to convince troops that mental illness is treatable and should not be looked upon with shame or embarrassment.

"I was very impressed to know they were doing that," Gunter said of the armed forces' stigma campaigns.

Societal stigma also can hamper treatment if people don't receive the support they need from family and friends, she said, adding that all too often, people diagnosed with a mental illness find their loved ones acting differently toward them.

"It affects their network of support," Gunter said. "If you were diagnosed with cancer or diabetes, you'd tell everyone and you'd be supported and prayed for and nurtured. If you tell people you have been diagnosed with a mental illness, you won't necessarily receive that same level of support."

Misconceptions and ignorance regarding mental illness fuel the stigma, Fitzpatrick added.

"People don't know where to go for treatment. They don't know what they're seeing," he said. "Mental illnesses are kind of where cancer was in the '50s. Not a lot is known about either the disease or the treatment."

That's why problems such as depression and anxiety are becoming more accepted -- the spotlight has shone brightest on these disorders, creating better education among the populace, he explained.

However, media portrayals of mental illness sometimes foster and reinforce people's worst fears.

Mental illness usually hits the news when tragedy has struck, Fitzpatrick said, such as when U.S. Rep. Gabrielle Giffords was shot in Tucson, Ariz., last January. Jared Lee Loughner has been charged in the case.

"The booking photo of Loughner in Arizona brought the cause of battling stigma in this country back about four steps, and it was run over and over and over," Fitzpatrick said.

It's often no better in fictional accounts of mental illness. Gunter said that people with a disorder rarely are given sensitive treatment in movies and on television, instead often portrayed as deranged lunatics.

"If you see mental illness in the media, a lot of times those illnesses are shown in people who are a real danger to society," she said.

To help end the stigma attached to mental illness, NAMI has created a program called Stigma Busters, which encourages people to report portrayals of mental illness that reinforce stereotypes and promote prejudice.

"We push back when we see stigmatizing language, and the media has gotten more responsive," Fitzpatrick said.

Another NAMI program, Breaking the Silence, goes into classrooms to teach school kids about mental illness, Gunter said.

"You would be so surprised about the lack of information these kids have regarding mental illness," she said. "We are teaching them to change this idea of mental illness."

Study shows racial disparity in treatment for depression

By The Record (Hackensack N.J.)

African-American senior citizens are significantly less likely than whites to be diagnosed and treated for depression, a Rutgers University study concluded.

Researchers reviewed five years of national data from the U.S. Medicare Current Beneficiary Survey, looking at the financial, insurance and health-care use information of 33,708 beneficiaries from 2001 to 2005.

The Rutgers study, to appear in the February edition of the American Journal of Public Health, found that depression diagnosis rates were 6.4 percent for non-Hispanic whites and 4.2 percent for African-Americans.

Researchers believe that many African-Americans are depressed but aren't getting the diagnosis or help they need, said Ayse Akincigil, lead researcher and an assistant professor at Rutgers School of Social Work.

While other studies have looked at people of all ages, Rutgers researchers chose to study Medicare beneficiaries because depression is a significant and often under-treated health problem for older adults.

Economic differences were found to play a role in detection rates. African-Americans in the study sample, for example, were less likely than non-Hispanic whites to have private insurance to supplement Medicare.

“Whites use more antidepressants than African-Americans,” Akincigil said. “We presume they have better access to doctors and pharmacies and more money to spend on drugs.”

In addition to economics, it may be that African-Americans are less likely to seek help because of the perceived cultural stigma, or that some poorer neighborhoods have far fewer therapists and doctors who treat depression.

“Are there cultural differences or systemic differences regarding health-care quality and access for treatment of depression?” said Akincigil, who hopes to conduct a smaller and more detailed study that better explore those theories.

Akincigil and the researchers say doctors who treat the elderly should routinely screen all their patients for symptoms of depression.

“There needs to more awareness of the ways in which depression can aggravate other common medical problems that older people tend to have, such as diabetes and heart conditions.”

Karyne Jones, president of the National Caucus and Center on Black Aged, agreed that doctors need to be more vigilant in recognizing symptoms. But at the same time, the African-American community needs to be urged to treat depression as a medical problem, Jones said.

“There needs to be more education that it's not just that Grandma's getting older or that Grandma's in one of her moods,” Jones said. “And of course, the joke in that black community is we don't go to therapy, we go to church. There's the thinking that these kinds of things can be solved by prayer alone.”

Colleges and suicide threats: when to call home?

Daniel Kim

By The Associated Press

The e-mail that arrived at Virginia Tech's health center in November 2007 was detailed and unmistakably ominous. It concerned a Tech senior named Daniel Kim and came from an acquaintance at another college.

“Daniel has been acting very suicidal recently, purchasing a $200 pistol, and claiming he'll go through with it,” the e-mail read, adding details of a reported previous suicide attempt with pills. “This is not a joke.”

By the time Virginia Tech told Daniel's father, William Kim, about that e-mail, it was too late.

A few weeks after it was sent to the school, he spoke with his son for the last time, Daniel indicating all was well and after final exams he'd be home for the holidays.

A few days after that, parked in his car outside a Target store near campus, Daniel fatally shot himself in the head.

William Kim

“If I'd known, I could have taken him to doctors, get him on medication, make him normal again,” William Kim, who owns a Washington, D.C., convenience store, said in a recent telephone interview, grief still echoing in his voice four years after the fact.

Virginia Tech's actions were all the more confounding coming just months after the murder-suicide rampage on the same campus by another student, Seung Hui Cho, which had supposedly prompted campuses nationwide to rethink their previous emphasis on confidentiality in treating troubled students.

“Who is going to take better care of him than his parents?” Kim said. “I never had the chance to do anything for him. That's a terrible feeling.”

In an agreement finalized by a judge last month in a multimillion-dollar lawsuit brought by the family, the Kims settled with Virginia Tech for $250,000, plus an endowed scholarship in Daniel's name. But William Kim also insisted that the agreement include language requiring Virginia Tech to notify parents of a potentially suicidal student unless it documents a reason not to do so.

The university, which admits no fault, maintains the language reflects policies already in place there under a 2008 state law, and wouldn't have made a difference for Daniel Kim anyway. It continues to insist that, after sending local police to check on the student, and despite the detailed e-mail, it had no reason to believe he was actively suicidal and thus didn't need to notify his family.

But the family's attorney, Gary Mims, insists the settlement goes further than the state law, which applies only to students treated by university mental health services. Now, he says, Virginia Tech must at least consider notifying parents if it receives an indication from any source a student may be suicidal. Several experts described it as among the strongest such policies in the country.

The issue of when colleges should notify parents their adult children may be suicidal remains fraught with legal, medical and ethical dilemmas. College policies, state laws and professional codes of conduct vary widely — and occasionally conflict.

Some mental health professionals call the Virginia Tech settlement the latest step in a trend they welcome: Threats to safety increasingly take precedence over preserving confidentiality. They emphasize that in many cases, involving parents is not only right, but helpful.

“There's some good evidence if someone is really sick, that involving family in their treatment planning, the medication, helping them stay on track, are really good things to do,” said Greg Eells, director of counseling and psychological services at Cornell University in New York, which has changed several policies to make notifying parents more common. “I think the (Virginia Tech settlement) is kind of affirming that.”

But many remain wary of top-down pressure on counselors to notify parents as the default option, even if such policies are well-intentioned and allow exceptions. Many students have just passing thoughts of suicide. Also, relationships with parents may be part of the problem. Involving them too readily might discourage some people from getting help, or complicate treatment once they do.

“The less flexibility we have, it actually compromises care,” said Mary-Jeanne Raleigh, director of counseling services at St. Mary's College in Maryland and president of ACCA, the American College Counseling Association. Overly rigid policies mean, she said, “I can't review what is best for the individual standing in front of me because the law is saying you have to x, y and z.”

Suicide is the second leading cause of death for college students, behind automobile accidents. A 2010 survey of counseling center directors found at least 133 college students had taken their lives in the previous year. The better indicator is probably the rate, estimated at about 6 to 7.5 per 100,000 — though that's only about half the suicide rate for similarly aged people not in college.

But while the research highlights the danger, it also sheds light on why these are tough calls for colleges. Warning signs aren't always as black and white as they were at Virginia Tech. A milder form of suicidal ideation — fleeting hopelessness or thoughts about death —is common among college-age students.

A 2009 survey of 26,000 students at 70 colleges found that roughly half reported having had at least occasional suicidal thoughts. But more than half of those said such thoughts lasted a day or less. Roughly 6 percent of undergraduates reported they had “seriously considered attempting suicide” in the last 12 months. Colleges must determine who's most at risk — typically those who have made detailed plans and acquired means such as a weapon or pills.

“Someone who's seeking help but says, `I have to admit I have these thoughts five or six times a day and they're kind of scary' — that's someone I wouldn't necessarily feel compelled to call the parents right away,” Raleigh said. “That's very different from the person I get a call from at 3 o'clock on a Saturday morning who's been drinking and has immediate plans to kill themselves.”

The 2010 survey of counseling directors found that when a client was considered a “suicidal risk” but didn't meet the state-law criteria for involuntary hospitalization, 41 percent wouldn't notify anyone else without a signed release from the student. Only 13 percent said they would notify family; 22 percent said they would notify a superior, and 19 percent said it would depend on the situation.

Why the hesitation to involve family? The data also show why colleges worry so much about any action that might discourage troubled students from seeking help: 80 percent of students who commit suicide, like Kim, never participated in campus counseling services.

“I'm in favor of notifying parents,” said Carolyn Wolf, a mental health lawyer who advises college officials. “These are kids who are 18, 19, 20 years old, they're legally adults, but I don't think they're developmentally adults at that point. Parents are much more involved in kids' lives these days for a longer period of time.” Still, she said, “you need to give some amount of flexibility to those people who are in the trenches.”

Wolf advises parents to remember that FERPA, the federal education privacy law, has clear exceptions for risks to health and safety, as do state laws. HIPPA, the federal medical privacy law, generally doesn't apply to colleges. And while counselors and psychiatrists may be unable to discuss a student they are treating, those rules don't apply to anyone else on campus; faculty and administrators can call home about behavioral issues.

And, Wolf points out, nothing forbids counselors from listening.

Parents “can call a counseling center and say, `I think this meets one of the (confidentiality) exceptions, but even if you can't tell me things, you need to listen to me give you history, give you information,“’ Wolf said.

William Kim's lawsuit against Virginia Tech contends the school broke its own protocol, which called for any student who had made even a gesture about suicide to see a psychologist on call immediately. Instead, officials discussed the e-mail the morning they received it, and dispatched a local police officer to Kim's off-campus residence.

The officer reported Kim “appeared to be OK” and that Kim said he didn't know the student who had sent the e-mail. That student appeared to know Kim through online gaming. The university also checked to see if Kim had purchased a gun. Apparently he had not, but did so a few weeks later.

Confidentiality laws would not have prevented Virginia Tech from contacting Kim's parents because he was not a patient of the university counseling center. But university officials decided not to reach out. Having received no other unsolicited indications from family, acquaintances or teachers that Kim might be suicidal, they concluded he was not a danger.

Ed Spencer, Virginia Tech's vice president for student affairs, acknowledged that the university has wide latitude to contact family if a student is suicidal, and said it would do so if it made that determination.

But, he said in a telephone interview, Daniel Kim “was never found to be suicidal by anyone here at Virginia Tech or by the Blacksburg police.”

Regardless of the detailed plans reported in the e-mail, altogether “there was nothing that added up that he was at all suicidal,” Spencer said. He added experts the university consulted backed up that view and “were surprised we went the extra mile” of checking on the gun.

But Mark Mills, a Columbia University psychiatrist retained by Kim's attorneys, found the e-mail alone represented clear evidence of a “psychiatric emergency” and that it was “irresponsible and reckless” that Virginia Tech failed to take further action to see if Daniel needed help.

When William Kim asked university officials why they hadn't told him about the e-mail, he says they told him it was “unnecessary.”

Kim responded: “It was unnecessary? My son's life was in danger, and you didn't think it was necessary?”

“They didn't call his teachers, other students, they didn't call me,” said Kim, who emphasized he was not angry at Virginia Tech as a whole. “Nothing was done whatsoever to save him.”

Daniel Kim was a happy kid, said his father, who only later learned his son had agonized about his perceived resemblance to Cho and experienced anti-Korean slurs after the shootings on campus the April before he took his own life.

Only later did William Kim learn his son had secluded himself for two weeks in his dorm — the same building where Cho killed his first two victims.

“When somebody's life is in danger, all the privacy, that should go out the window,” he said. “No matter how bad your relationship with your parents, when something like that happens you want to know.”

He added: “He was suffering at that school. We had no idea.”

Post Secret faves for the week

Holidays can ramp up shopping addiction for some

By Chicago Tribune

With the hours ticking down until Christmas, it's the high-risk season for compulsive shoppers.

In the past, those who struggled to control their urges could steer clear of the malls. But with online daily deals beckoning 24 hours a day — Today only! Free upgrades! Half off your entire purchase if you act now! — reining in those impulses is more challenging than ever, say experts.

“There are just a lot of triggers out there,” said April Lane Benson, a New York psychologist who has treated problem shoppers for 15 years.

An estimated 15 million Americans have little control over their spending, according to the American Psychological Association. For them, just checking email during December can be like navigating a minefield.

While Kiratiana Freelon, 31, wouldn't say she's a shopaholic, she acknowledged it's easy to buy things you don't need, especially with the proliferation of coupon sites. “I get excited about a bargain … I rarely pay full price for anything,” she said.

“I felt like this was the year the whole thing just got out of hand … especially when I looked at the deals I actually used,” said the Chicago writer, who has spent about $200 for unredeemed “discounts,” including a juice cleanser.

To curb spending, she recently deleted the Groupon app from her phone. “At least it gives me more time to think before I hit the buy button,” she said

The National Retail Federation in 2010 found that online shoppers start their holiday buying earlier and are more apt to grab a few items for themselves than those in retail outlets.

Anonymity and accessibility are big factors in blowing cash online — but so are the often complicated emotions intertwined with December, when anything less than an idealized Hallmark holiday can seem like a letdown, clinicians said.

“There's disappointment, loss, bad memories … and shopping is one way to anesthetize ourselves against those feelings,” explained Benson, author of “To Buy or Not to Buy: Why We Overshop and How to Stop.” “If you want love and affection, 12 pairs of boots isn't going to do it.”

A normal, pleasurable activity turns dysfunctional when it becomes a constant preoccupation, experts say. In the extreme, it results in harmful consequences — such as bankruptcy, foreclosure or divorce. Also, it's often done furtively, such as hiding purchases and bills from a spouse and can escalate into criminal behavior, such as retail theft or credit card fraud.

Compulsive buying isn't listed as a distinct disorder in the Diagnostic and Statistical Manual of Mental Disorders — the bible of psychiatry — but it is under review for the new edition, the first overhaul in 20 years, due out in 2013.

Generally, it is treated as an impulse control disorder, such as gambling. The pulse-pounding, heart-racing euphoria is the same, whether hitting a jackpot or scoring a coveted bag, said Vickie Lewis, of Proctor Hospital in Peoria, Ill., which specializes in addictions.

In the last year, calls about shopping and spending to Proctor's 800 number have increased by 50 percent, Lewis said. The usual protocol for treating such disorders is outpatient therapy and 12-step groups, but in some cases, can include hospitalization.

In one landmark case in 2001, a Chicago woman, Elizabeth Roach, embezzled nearly $250,000 from her employer to finance her splurges, which included a $9,000 purse and a $7,000 belt buckle. It was the first time a federal judge reduced a sentence, citing a shopping addiction.

“It's not about getting things,” her attorney told the court. “It's about trying to find a way to deal with the pain.”

One suburban Chicago woman can relate. A few years ago, she started accumulating “tons” of jewelry — to the point that she was secretly draining her and her husband's retirement savings.

“Everything was just so shiny and pretty … I'd look down at this bracelet and it just made me happy,” said the woman, who did not want to be named because she was embarrassed by her spending struggle.

Only when confronted by her husband, did she seek help. Eventually, she came to realize her obsession coincided with her only child leaving home that she came to see the luxury goods as a substitute.

Still, for all the heartache, mixed messages abound. People who would be concerned by other out-of-control behaviors wink at “retail therapy” or view Black Friday as frivolous fun, Lewis said.

“Society just doesn't recognize it,” she said. “If this were heroin, people would be devastated … but with shopping, the reaction is: You go girl!”

Niquie Dworkin, a clinical psychologist in Lakeview, Ill., said clients often come in for other issues, such as depression or anxiety and, as therapy progresses, realize they have a spending problem. “If you're overwhelmed by your feelings, it's about reaching for something quick.”

The ease of technology — along with credit — takes the speed to a whole new level. And while addicts can avoid alcohol or cigarettes, it's almost impossible to live without a computer, experts said.

“Everyone who is struggling … is able to engage more (in destructive habits) than in the past,” Dworkin said. “It's just a click … and it's dangerous.”

Seasonal affective disorder may be more than SAD-ness

By St. Louis Post-Dispatch

Seasonal affective disorder -- the blues because the days are shorter and gloomier -- gets a lot of press this time of year and a lot of the pop-culture remedies are at best inconsistent and at worst meant to sell light therapy lamps. That's because light therapy appears to be the first responder when SAD is self-diagnosed.

But self-diagnosis may not be smart, mental health professionals say.

Dr. Miggie Greenberg, associate professor of psychiatry with St. Louis University, says treat seasonal affective disorder like depression; that's what it is.

What's at risk is people assume they have a temporary case of SAD and they buy SAD lamps expecting relief. The condition instead may linger or get worse.

With so many possible conditions that spark the depression, light therapy is just one of several options for treatment, Greenberg says.

"Many people notice depression more in the winter," Greenberg said. But much of that can have to do with the stress of the holidays, the onset of gloomy weather during season changes and even job or economic stress, she said.

"SAD has some symptoms that are more typical of the seasonal aspect -- weight gain, fatigue, more sleepiness, and lots of regular old depression. They're hard to distinguish."

Lori Tagger, a psychologist with St. Anthony's Psychological Services, says SAD isn't only a winter disorder. "It's any disorder that seems connected with a (time of year), she said. So length of the day may or may not be an issue, she said.

That's why at least counseling may be in order, or even medication, she said. Like any depression, it can be left to languish for too long, she said.

"If it gets in the way of your ability to function, you need to seek professional help. It can be treated with therapy or medication," she said.

The National Institute of Mental Health says of SAD: "Some people experience a serious mood change during the winter months, when there is less natural sunlight. SAD is a type of depression. It usually lifts during spring and summer. SAD may be effectively treated with light therapy. But nearly half of people with SAD do not respond to light therapy alone. Anti depressant medicines and talk therapy can reduce SAD symptoms, either alone or combined with light therapy."

The symptoms, says Mental Health Institute, include:

• Sad, anxious or "empty" feelings.
• Feelings of hopelessness and/or pessimism.
• Feelings of guilt, worthlessness or helplessness.
• Irritability, restlessness.
• Loss of interest or pleasure in activities you used to enjoy.
• Fatigue and decreased energy.
• Difficulty concentrating, remembering details and making decisions.
• Difficulty sleeping or oversleeping.
• Changes in weight.
• Thoughts of death or suicide

OCD can make holidays a tough time

By St. Petersburg Times

Elizabeth Glass remembers staying up all night wrapping presents, trying to make the holidays picture-perfect to meet her own imagined expectations.

The next morning, her husband made a flip comment about one of the gifts. Certain she had failed, Glass threw the family Christmas tree out the patio door.

Glass, 49, suffers from Post Traumatic Stress Disorder with Obsessive Compulsive Disorder. Her 14-year-old son also suffers from OCD and experiences heightened symptoms during the holiday season, though less so in recent years thanks to treatment, Glass said.

She wants people with anxiety disorders to know there are ways to cope.

"There's help out there," Glass said. "Now I don't stay in the house. I don't wallow in my head. I get better every year."

Obsessive Compulsive Disorder affects about 2.2 million American adults annually, according to the National Institute of Mental Health. Pressures associated with the holidays can worsen the condition and other anxiety disorders, as triggers become more intense and frequent, said Dr. Rahul Mehra, director of Mental Health Care, Inc. in Tampa.

"Even those of us not suffering from anxiety disorders put undue pressure on ourselves during the holidays," Mehra said. "Someone with OCD, a baseline anxiety condition, is likely going to be affected."

Mehra said symptoms of OCD include unwanted repetitive thoughts and compulsive behaviors. Examples include fear of contamination, fear of losing control, a desire for perfection, persistent negative thoughts, over-eating and under-eating .

Around the holidays, Mehra encourages patients to stay hydrated, avoid alcohol, get adequate sleep and have a full supply of medication prior to pharmacies closing for the holiday. He recommends OCD patients prepare themselves ahead of time for outings. For example, he suggests patients worried about contamination bring a disposable dish to a potluck.

"This time of year it's best to know what your triggers are and do what works best for you," Mehra said.

Christian Maurer, 25, was diagnosed with OCD in 2003 after he became obsessed with washing his hands. His triggers include germs and being around large groups of people. Maurer, of Brandon, said his symptoms can get worse near the holidays. He takes three anti-depressants daily and receives outpatient counseling through Mental Health Care, Inc. His fear of germs has lessened but he still experiences racing thoughts.

"With having family over, it's just too many people," he said. "Once in a while it's too much, and I go off by myself to calm down. I step out of the room for a little while."

Elizabeth Glass said loneliness used to be a trigger for her during the holidays.

She grew up in what she calls a dysfunctional home (her family history includes bipolar disorder) and since her divorce, her only family is her son. In the past, she turned to alcohol to stop herself from obsessing about negative thoughts. She battled a misconception that a less-than-ideal Christmas (the kind in television and movies) was unacceptable.

Now sober, she turns to Alcoholics Anonymous and counselors at the Panos Center, a mental health center near her home in eastern Hillsborough. She takes anxiety medication. To quiet her mind, she focuses on volunteering and meditating rather than shopping and sending cards to acquaintances.

Glass will attend Christmas Eve service at Unity Church in Tampa, then spend Christmas Day at home with her son and their pug, Charlie Bear.

"Getting out of isolation is important," Glass said.

Maurer and Glass said their advice to others is to seek counseling. Mental Health Care, Inc. has offices throughout Hillsborough County offering psychiatric support year-round. If this holiday is tough, the next one doesn't have to be, Glass said.

"Accept the gift of life, don't get caught up in the wrapping paper," she said.

Teen conquers eating disorder with help of her family

By St. Louis Post-Dispatch

Katherine “Katie” Seal, 19, sat in a Kayak's Coffee & Provisions eating a slice of zucchini bread and drinking a latte, recalling her life-threatening bout with anorexia and bulimia.

It's not something she likes to discuss. “It's blurry now,” says Katie, 19. “I just remember it was not about the food. It was more, eating bad foods made bad things happen.”

Annie Seal, Katie's mother, sat knitting a scarf. She remembers every detail.

HOW IT STARTED

Symptoms began about four years ago for Katie when she was 15. She began to get distant, angry.

“We just thought she was an unhappy teenager,” Annie Seal said. “Just normal mother-daughter friction. We bought books on parenting.”

Then her parents saw her eat less and less at home. She became obsessed with calories and fats. She saw herself as fat, even though she was a healthy weight.

Her mood changed. She isolated herself. She lost friends and enthusiasm. Her food choices became black and white, good food and bad food.

“We'd bring home a pizza and she wouldn't eat any of it,” Annie Seal said. “Bad food.”

The family eventually learned that Katie was eating about 500 calories a day, then purging -- vomiting her meals in private. The process had damaged her young body.

Katie was diagnosed only as stressed and anxious, her mother said.

Annie Seal still can't believe that the doctor issued that diagnosis without speaking with any family member. “When I talked to the doctor, I asked her if Katie had told her about (any disturbing behavior) and the doctor said no, and … she said maybe she should take another look at the diagnosis.

”That was just criminal, criminal.“

The misstep delayed Katie getting into treatment for more than a month, Annie Seal said.

A physician at Cardinal Glennon Children's Medical Center diagnosed Katie's eating disorder in January 2008.

The doctor ”said forget returning to school -- start treatment now or she's not going to finish school,“ Annie Seal said.

The family chose McCallum Place, a treatment facility in Webster Groves.

The insurance company would only pay for outpatient treatment, even though the doctor at Cardinal Glennon said she needed residential care.

By the time she got into treatment, Katie's digestive system had gone into chaos, retaining fluids, inflammation and numerous imbalances.

”Her digestive system had shut down,“ her mother said. ”It just didn't work any more. It could be fatal.“

Because of the imbalances, people with some forms of anorexia and bulimia actually gain weight, Annie Seal said.

”We don't discuss her weight now, just her health,“ Annie Seal said.

Katie started an intense 10-hour-a-day program.

Nerinx Hall, Katie's high school in Webster Groves, helped her keep up with her studies.

Meanwhile problems persisted with medical insurance.

Every time Katie would improve and progress to another level of care, the company would cut her off and say she didn't need more treatment, Annie Seal recalled. ”Then she'd relapse and we had to start over -- three times this happened. They see it as a mental illness and they won't cover it as a disease.“

EATING DISORDERS

Eating disorders have the highest death rates among mental disorders, according to the National Association of Anorexia Nervosa and Associated Eating Disorders.

But death rates are undercounted, the association said, because death certificates list heart failure, kidney failure, organ failure, malnutrition or suicide, but not eating disorder.

Misinformation creates a stigma that anorexia is an emotional problem, mostly of young girls who want to look like runway models and be popular, Annie Seal said.

Untrue, she said. ”The girls tend to be high achievers, people who push themselves,“ she said.

Katie added, ”Everyone thinks it's something rich white girls get.“ Patients at McCallum were black and white, she said. Some were older; some were boys.

”It's a predominantly biologically based disease,“ Annie Seal said. ”But we don't treat it like a disease. We treat it like a secret.“

‘THE WHOLE FAMILY IS INVOLVED'

Seven months after being diagnosed, Katie was back to being the person her family thought they'd lost.

”With anorexia, the whole family is involved,“ Annie Seal said. ”She went to therapy, the family went to therapy.

“We all were in this together. As a family, it's brought us closer.”

Today, Katie is a sophomore at the University of Missouri-Columbia, majoring in sustainable agriculture with an emphasis on community food systems.

Since her daughter's bout with anorexia, Annie Seal has been advocating for Missouri to require insurance companies to treat eating disorders like a physical disease. Legislation has languished three years, she said.

She's part of the Dahlia Partnership, affiliated with the National Eating Disorders Association. In February, she plans to help lead a rally in Jefferson City to raise awareness.

Bipolar disorder and women: Common triggers during the holidays

By R. Elizabeth C. Kitchen
Yahoo! Contributor Network

Bipolar disorder is difficult to deal with anytime of year, but during the holidays it can be even more difficult. There are temptations, exhaustion, stress and relatives that can make keeping a normal and steady schedule next to impossible. It is important for women with bipolar disorder to know what the possible difficulties will be so that they can be plan ahead and be prepared for them. Being prepared will allow you to plan and reduce the impact that these have on you. Also, if you anticipate them having a significant impact, you will have a chance in advance to talk to your doctor about ways to get prepared for the holidays and the stressors they may bring.

Your Schedule

There is a chance that your schedule around the holidays could get disrupted and could be a bit less normal than what you are used to. Keeping a normal and steady schedule is important for maintaining bipolar disorder, so these disruptions could possibly trigger symptoms, such as a mood swing. It is important that you do what you can to stick to your sleep, eating, exercise and other scheduled activities.

Time Change

The holidays strike during the winter and in this hemisphere, this means that the nights are longer and the days are shorter. Some bipolar disorder patients experience mood swings related to this change. In the northern hemisphere, depression also often tends to be more common during the fall and winter seasons.

Spending More Money than Usual

If during your manic or hypomanic episodes, grandiose gift-giving or excessive spending are known habits, this could be a difficult time of year for you. It is important to plan ahead so that you do not spend more than you can realistically afford. Talking to your therapist and trusted friends and family members are ways to help with this.

Getting Over-Stimulated

Anxiousness and excitement are common emotions for the holidays, but when you have bipolar disorder, these emotions may be a bit more exaggerated than usual. You will be getting ready for parties and celebrations, and shopping and decorating. All fun activities, but they can also over-stimulate you. Excess stimulation has the potential to trigger mania or depression.

Alcohol

During the holidays, holiday cocktails and champagne are often flowing, but it is important not to imbibe too much. Alcohol has the potential to make you susceptible to mood swings, ruin sleep and interfere with your medications. So, if you choose to have a drink, make sure that you talk to your doctor first.

Feeling Like You Must Celebrate

The holiday hype is all around us, but it is important to remember that if celebrating the holidays are just not your thing, that this is perfectly okay. The last thing you want is to become depressed during the holidays because you feel pressured to celebrate something that you really do not want to take part in. Being depressed, especially this time of year, can result in isolation and this may lead to further issues.

Skipping Medications

The holidays are busy and if you are super busy, you may accidentally forget to take a dose. Missing a dose may make your mood less stable. So, it is important that you take the necessary measures to remember to take your medications on time. Setting an alarm and using a daily marked pill case are two ways to help remember to take your medications.

Study finds Twitter reflects Americans’ mood is gloomy

By The Salt Lake Tribune

Our overall happiness is apparently in decline.

How do we know? It’s on Twitter.

A team of mathematicians from the University of Vermont analyzed 4.6 billion Twitter messages worldwide over 33 months. They assigned happiness grades to more than 10,000 of the most common words, crunched all the numbers and plotted them on a graph that shows a gradual downward slope during the past year and a half or so, through mid-September.

Their gloomy findings have just been published in PLoS ONE, an international, peer-reviewed online journal that publishes papers from various fields in science and medicine.

Not all the news is bad. The researchers say their measure of collective happiness tends to spike on Christmas — and on many other holidays, too, for that matter. Moreover, happiness tends to peak on weekends, and plummet, at least relatively, on Mondays and Tuesdays.

The study’s data include 46 billion words written by 63 million Twitter users between Sept. 9, 2008, and Sept. 18, 2011. Each of the most commonly used words was assigned a number on a happiness scale of 1 to 9 — 9 being the happy extreme. “Laughter,” for example, registered 8.50; “the,” 4.98; and “terrorist,” 1.30.

Twitter is the social networking service that restricts messages to 140 characters or fewer. Those messages can be seen as a reflection of an individual’s mood of the moment — as opposed to “a longer-term reflective evaluation” of the person’s life. Twitter users tend to be on the young side, but all age groups are represented in the sample, said Peter Dodds, an applied mathematician and the study’s lead author.

“Twitter is a signal, just like looking at the words in The New York Times or Google Books. They’re all a sample,” Dodds said in a statement announcing the findings,

In a previous study, aided by aggregative websites and computer technology, Dodds and his UVM colleague and co-author Chris Danforth, a computer scientist, did a happiness analysis of 10 million blog sentences that began “I feel” or “I am feeling.” They found, among other things, that overall happiness dropped on Sept. 11 anniversaries and on June 25, 2009, the day Michael Jackson died.

The Twitter study produced similar results from a much larger sample. Jackson’s death produced the single-biggest drop in a single day. Other low points were registered on Sept. 29, 2008, when the U.S. government pledged to buy up banks’ toxic assets; and various natural disasters in 2010 (Chilean earthquake in February, U.S. storms in October) and 2011 (earthquake and tsunami in Japan).

Seasonal cheer is apparently robust, however. Certain dates, on which happiness sharply deviates from nearby dates, are termed “outliers” — and Christmas is one of them.

“For the outlying happy dates, 2008, 2009 and 2010, Christmas Day returned the highest levels of happiness, followed by Christmas Eve,” the article states.

Holiday Blues May Signal Depression

By HealthDay

The holidays can be a particularly difficult time for people suffering from depression.

Experts from Gottlieb Memorial Hospital, part of the Loyola University Health System, said they are bracing for an increase in self-destructive behavior. They noted however, there are ways to recognize when a person is depressed and intervene before they end up in the emergency room.

"For those who have no support system, no friends, family, loved ones or even co-workers, the holidays can prove very deadly," Dr. Mark DeSilva, medical director of the emergency department at Gottlieb Memorial Hospital, said in a hospital news release. "Everywhere, there are signs of gatherings, gift exchanges, happiness and love. If you are not experiencing what the rest of the world is enjoying, it is very bitter."

Although the holidays can bring out desperate acts in unstable people, he pointed out that there are usually a number of warning signs leading up to this behavior. DeSilva offered the following tips to help identify these red flags:

• Being antisocial. "Most people are busy going to social gatherings, shopping, attending events and connecting with friends," DeSilva said. "Look for those who shun social interaction or who consistently do not attend events that they say they will."
• Being angry."The person expresses sarcasm, unhappiness or criticism of others' joy in the season and is consistently pessimistic," DeSilva said.
• Abusing drugs or alcohol. "Beer or cocktails, readily available throughout the holidays, or illegal drugs, are overindulged to numb the pain the individual is feeling and offer an escape from reality," DeSilva explained.
• Missing work or other events. "Facing others who are happy and bright is often too difficult for those feeling the holiday blues," DeSilva said. "They may be consistently absent or very late to work or no-shows at anticipated social engagements."
• Excessive sleepiness. "Depression often takes the guise of extreme fatigue or tiredness. The body shuts down to form an escape from the everyday world," DeSilva cautioned.

Anyone who recognizes these behaviors in a friend or acquaintance should reach out to that person right away, particularly if they've been hit hard by the economic downturn.

"By recognizing when a person is in trouble, and speaking out, you may not only save them a trip to the [emergency department], but also save a life," DeSilva concluded.

Facebook launches suicide prevention tool

By St. Joseph News-Press, Mo.

In the digital age, a cry for help can be a Facebook status update.

Tyler Clementi, a Rutgers University student who committed suicide after a clandestine video surfaced online, wrote his intention on his Facebook page shortly before his death.

Now, Facebook friends can do more to help. A new feature allows friends to report troubling posts, comments or status updates to the social media website. Facebook administrators will then message the person-in-question with the National Suicide Lifeline hotline, (800) 273-8255, and a link to an online chat with a Lifeline Crisis Center employee.

Facebook started collaborating with the National Suicide Prevention Lifeline in 2006 to help pinpoint users in trouble. The new user-driven feature helps address other signs of depression or suicidal thoughts, such as change of behavior or loss of interest.

"Sometimes just the change in people's statuses might make people more aware that something may be going on," said Dr. Susan Shuman, a psychologist for The Center in St. Joseph. "Somebody who posts daily or who posts with a positive, upbeat attitude and suddenly stops for a while, that could be a warning sign, too, for some people."

The online chat with a professional might also be a good resource for someone who doesn't know where to turn, Dr. Shuman added.

Though not himself a Facebook user, Garry Hammond is a little more skeptical of the feature. The CEO and president of Family Guidance Center for Behavioral Healthcare in St. Joseph would prefer the area's Access Crisis Intervention hotline, (888) 279-8188, be used in times of trouble. Over the phone, a counselor can learn a lot about the caller's distress level from the tone and cadence of his or her voice, Mr. Hammond said.

If in a severe crisis, the caller can also meet with that counselor within the hour. Of the 489 distress calls the Northwest Missouri Area Access Crisis Intervention Center received in the past three months, 169 resulted in face-to-face encounter.

"Digital and electronic (mediums) can be useful for education and prevention but not for intervention," Mr. Hammond said. "Just imagine you think you have a medical issue. Do you want to actually see a doctor or talk to a doctor or have a digital interaction where you can't take your pulse or your blood pressure?"

Dr. Shuman agrees that verbal interaction with a counselor is often more telling than nonverbal, but calls the Facebook application a good first step to preventing suicide.

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Ashes remain

There is a band I've recently discovered that I'd like to share with you guys. It's a Christian rock band called Ashes Remain. (Don't let the Christian aspect discourage you from listening... If you're a rock music fan, it's some great rock music.) Their songs deal with a lot of depression-type issues and about having faith in getting through the pain.

If you want to check out the lyrics to their entire debut album, click here: http://www.azlyrics.com/a/ashesremain.html.

My favorite song of theirs so far is "Right Here." It's all about someone helping a "broken" person through tough times. You can listen to it in the YouTube video below, and here are the lyrics:

"Right Here" by Ashes Remain

I can see every tear you've cried

like an ocean in your eyes

All the pain and the scars have left you cold

I can see all the fears you face

through a storm that never goes away

Don’t believe all the lies that you’ve been told

I’ll be right here now

to hold you when the sky falls down

I will always

be the One who took your place

When the rain falls

I won’t let go

I’ll be right here

I will show you the way back home

never leave you all alone

I will stay until the morning comes

I’ll show you how to live again

and heal the brokenness within

Let me love you when you come undone

When daybreak seems so far away

reach for my hand

When hope and peace begin to fray

still I will stand

When the rain falls I won’t let go

I’ll be right here.

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Some depressed people do worse on medications

By Reuters 

According to a new look at past antidepressant trials, up to a fifth of patients on Cymbalta and similar medications may actually do worse than those given drug-free placebo pills.

Researchers found that patients' symptoms over the first couple months of antidepressant use separated them into "responders," who got progressively better, and "non-responders," who didn't improve with treatment but may still have suffered side effects.

However, "It's difficult to say a priori who will be in which group," Ralitza Gueorguieva, the study's lead author from the Yale University School of Medicine in New Haven, told Reuters Health.

The findings highlight the importance of identifying as soon as possible which patients will and won't respond to certain drugs, her team said.

The researchers combined data from seven studies that randomly assigned patients to receive Eli Lilly's drug Cymbalta (known generically as duloxetine), other antidepressants, or a placebo pill for two months. Those trials involved a total of about 2,500 people with major depression.

People getting the placebo tended to report small, gradual improvements in depression symptoms. On the other hand, those on Cymbalta or another antidepressant fell into one of two categories: most had steeper, steady improvements in depression symptoms, but a sizeable chunk didn't seem to get any better.

About four in five patients on all antidepressants were responders. For Cymbalta in particular, about 84 percent of patients improved and 16 percent did not.

Medication responders saw significantly bigger improvements in their depression symptoms than patients assigned to the placebo. Non-responders, however, did worse.

Differences between antidepressant responders and non-responders were seen as early as a week or two into treatment, and the researchers wrote in their Archives of General Psychiatry report that initial improvements seem to predict who will have a better outcome on Cymbalta, along with the other drugs.

"You know within the first couple weeks of starting a treatment who's the most likely to benefit because they're already starting to show improvement," said Dr. Michael Thase, a psychiatrist from the University of Pennsylvania Perelman School of Medicine who wasn't involved in the new study.

"The first few weeks are revealing, and obviously if the patient's getting worse instead of better, I would use that as a strong indicator that this particular treatment isn't likely to work," he told Reuters Health.

"I think this finding holds true for the antidepressants that are most commonly used today," he said of the gap between responders and non-responders.

Thase pointed out that side effects of antidepressants, such as stomach problems and poor sleep, could make some patients score lower on measures of depression -- perhaps explaining the worse symptoms seen in non-responders compared to placebo patients.

He added that if patients don't benefit from a first antidepressant, they could still respond to a different type of drug, although the chances fall with each successive treatment attempt.

Another scientist said the latest research has been trying to pick out certain patient characteristics -- genetics or specific depression and anxiety symptoms, for instance -- that could help determine who will end up in the responder category, and who won't see any benefit from individual drugs.

"If you can identify people who would be potential responders to a particular medication...it would be a great, huge advantage for the field," said C. Hendricks Brown, who has studied depression treatments at the University of Miami Miller School of Medicine, but wasn't linked to the new research.

Gueorguieva agreed. "Identifying variables that are associated with response is a very important question that we haven't quite tackled," she said.

One of the study's authors is an employee of Eli Lilly and another is on the company's scientific advisory board.

'Love Hormone' May Buffer Kids From Mom's Depression

By HealthDay

Children born to mothers with postpartum depression are at increased risk for mental health problems, but a hormone called oxytocin may reduce the risk, according to a new study.

Oxytocin, which is produced naturally in the body and has been associated with feelings of love and trust, may help protect kids from the negative effects of maternal depression, the researchers found. A synthetic version of the hormone is available as medication.

In the study, Israeli researchers looked at 155 mother-child pairs. By the time they were 6 years old, 60 percent of children born to mothers who were consistently depressed for the first year after giving birth had mental health problems, mainly anxiety and conduct disorders.

Among the 6-year-old children whose mothers did not have postpartum depression, only 15 percent had mental health problems, the investigators noted.

The study also found that children born to mothers with extended postpartum depression were less verbal and had lower levels of playfulness and creativity, less engagement with their mothers, diminished social involvement, and less empathy for the pain and distress of others.

These children and their mothers also had disordered functioning of the oxytocin system, as shown by lower levels of oxytocin in their saliva and a variant on the oxytocin receptor gene that increases the risk of depression, according to study leader Ruth Feldman, a professor in the psychology department and the Gonda Brain Sciences Center at Bar-Ilan University, and colleagues.

Among the children born to depressed mothers, the 40 percent who did not have mental disorders by age 6 had normal functioning of the oxytocin system and normal levels of oxytocin in their saliva.

The study was slated for presentation Thursday at the annual meeting of the American College of Neuropsychopharmacology, in Hawaii.

"We found the functioning of the oxytocin system helps to safeguard some children against the effects of chronic maternal depression," Feldman said in a college news release. "This study could lead to potential treatment options for postpartum depression and methods to help children develop stronger oxytocin systems."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Psych Episode Near Childbirth May Presage Bipolar Disorder

By HealthDay 

New mothers who experience a psychiatric disorder within 30 days after giving birth have an increased risk of developing bipolar disorder, according to a new study.

Researchers examined data from more than 120,000 Danish women born between 1950 and 1991 who had received first-time psychiatric care either as an outpatient or an inpatient for any type of psychiatric disorder other than bipolar disorder. Of those women, 2,870 had first-time psychiatric contact within a year of giving birth to their first child.

During follow-up, more than 3,000 of the 120,000 women were diagnosed with bipolar disorder. Of those, 132 had first-time psychiatric contact within a year after giving birth.

Fifteen years later, bipolar disorder had been diagnosed in nearly 14 percent of women with initial contact within 30 days after giving birth compared with less than 5 percent of women who had initial contact one month to one year after giving birth, and 4 percent of those with initial contact one year or more after giving birth.

Twenty-two years later, bipolar disorder had been diagnosed in 19 percent of women who had initial contact within a month of giving birth, compared with 6.5 percent of those who had initial contact within a month to a year after childbirth, and 5.4 percent of those with initial contact one year or more after giving birth.

The study appears online in the journal Archives of General Psychiatry.

"Childbirth has an important influence on the onset and course of bipolar affective disorder, and studies have shown that episodes of postpartum psychosis are often best considered as presentations of bipolar affective disorder occurring at a time of dramatic psychological and physiological change," the researchers wrote. "It is also clear, however, that a high number of women with the new onset of a psychiatric disorder in the immediate postpartum period do not receive a diagnosis of bipolar disorder."

"The present study confirms the well-established link between childbirth and bipolar affective disorder and specifically adds to this field of research by demonstrating that initial psychiatric contact within the first 30 days postpartum significantly predicted conversion to bipolar affective disorder during the follow-up period," the study authors concluded. "Results indicate that the presentation of mental illness in the early postpartum period is a marker of possible underlying bipolarity."

While the study suggests an association between psychiatric episodes soon after childbirth and bipolar disorder, it does not show cause and effect.

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