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on: Friday, 29 August 2008 17:20
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QUOTE (Darken @ Mar 13 2008, 04:52 PM) * Hi Everyone, Let me first thank you all for your well wishes and offerings of support. Your comments, suggestions and support really did help me seek the proper help for my condition. If not for sincere comments like those from Soleil and Burgy who knows where I'd be. Angel brought me your comments while I was in the hospital and it really made my day. For those who have been following this thread let me update you on what happend. I was in danger of being taken to the hospital against my will after Angel became involved. She made calls and had the abilty to do just that, yet gave me the space and time to prepare my life for this big change. On the day I was to make the call to the hospital I chose..everything seemed to go wrong and my planning and choices went up in smoke. I was in danger of going to a general hospital and that is something I was not prepared to accept. In the end my fears and panic were dismissed as I finally got the courage to call the hospital myself and they agreed to admit me that night. Let me make this next part clear...my hospital stay was the most amazing experience of my life. After a night and day of severe anxiety because of where I was and some of the people that were in this ward, I realised many of the 35 people in the unit were just like me. My choice of hospitals was certainly the best decision I ever made as the structure of your help in this particular hospital is all up to you. Aside from seeing the Pdoc every morning the rest of my day was my choice. If I wanted to attend one of 13 groups I could, if I wanted to sit in my room all day I could do that too. I obviously opted for the groups and this being my first experience at all with something like that I found myself really enjoying the interaction and information being presented. At the end of the first day I was literally a totally different person as opposed to when I went in. This was not due to any medication, it was merely the stress free environment and the ability to control my life and help in the way I needed to. By the end of the third day I truly did not want to leave. No outside pressures, no work, no home stress just the tools and people to help me get straight again. This coupled with Angel's renewed support made me feel like I haven't felt in years. I spent a week in the hospital and really felt I was ready to leave when the time came...as it turned out I most certainly was not. Let me briefly touch on meds. The Pdoc at first wanted to put me on Lexapro, I was not totally against that idea as I have seen many success stories on this very site (at least in the beginning). In the end though I did not feel a drug more geared for anxiety (which I do not have) was the best choice for me, nor did I want to deal with the side effects of SSRI's. After doing research and speaking to others on here I thought Wellbutrin might be a good start as it is a stimulant and may be better at treating just depression. The doctor listened to my concerns and agreed to begin with the WB. My first three days on this med were not good at all. They were concerned about seizures as I had an odd feeling in the front part of my head which developed into a killer headache for three days. I also had the blurred vision, dry mouth and a general uncomfortable 'physical' feeling. I discussed my concerns with the Pdoc and I agreed to give it time. After the third day the side affects disappeared and have not returned since. I did not knowingly experience the early 'kick' of this drug, although as I've said I felt incredible in the hospital....since getting out it seems to only help with a general feeling of a 'clear' head as opposed to the muddled mess I felt before. I am on the lower dose for the moment so perhaps if moved to the 300 mg I may find more benefits. I will not post my experience after the hospital on this post as I really wanted to convey my appreciation for all of your support and also to let people know who were thinking of, or are fearful of going to the hospital that the help there is invaluable. I chose a specific Behavioral Health hospital and I would encourage anyone else to do the same, from talking to people in there who have been through many different 'wards' the BH hospital was much less structured and far more geared to help yourself, rather then push in on you. This was the perfect receipe for me. Also none of them looked down on the fact that I was suicidal and almost went through with it, instead they worked on making me feel safe both in the hospital and out. Darken
(Darken)
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Depression & Mental Health FAQs
US Centers for Disease Control and Prevention (CDC) estimated 40 million
Americans living today will suffer from major depressive illness during their lives.

Seasonal affective disorder is major depression that appears in the fall or winter and goes away in spring, thought to be caused by lack of sunlight.



Postpartum depression occurs within four weeks of a women giving childbirth. Most new mothers suffer from some form of the �baby blues.� Postpartum depression, by contrast, is major depression, thought to be triggered by changes in hormonal flows associated with childbirth.

Catatonic depression is a rare form of major depression characterized by (at least two): Stupor, excessive motor activity, extreme negativism, peculiarities in voluntary movement, and repetition of other people's words or actions. - mcmanweb.com



Psychotic depression is a rare form of depression characterized by delusions or hallucinations, such as believing you are someone you are not and hearing voices.


According to the National Institute of Mental Health, approximately 18.8 million American adults, or about 9.5 percent of the US population age 18 and older in a given year, have a depressive disorder.
Depression is a chronic illness that exacts a significant toll on America's health and productivity.  It affects more than 21 million American children and adults annually and is the leading cause of disability in the United States for individuals ages 15 to 44.


Lost productive time among U.S. workers due to depression is estimated to be in excess of $31 billion per year.  Depression frequently co-occurs with a variety of medical illnesses such as heart disease, cancer, and chronic pain and is associated with poorer health status and prognosis.  It is also the principal cause of the 30,000 suicides in the U.S. each year.  In 2004, suicide was the 11th leading cause of death in the United States, third among individuals 15-24.


According to the World Health Organization, depression is presently on track to becoming the world's second-most disabling disease (after heart disease) by the year 2020.

Depression is responsible for some $87 billion a year in lost productivity in the US (a conservative estimate), and according to Bank One, is responsible for most lost work days in its employees after pregnancy and childbirth.

Additionally, one million people worldwide die by their own hand, most as a result of a mood disorder. Finally, the linkage between depression and a host of physical illnesses makes it arguably the world's greatest killer.

Research presented at the 56th Annual Conference of the Canadian Psychiatric Association shows a marked link between bipolar disorder and migraines.

The odds of migraine in persons with bipolar disorder were 40% higher than the general population.

Data obtained from 36,984 people aged 15 and over, who screened positive for manic or depressive episodes with migraine, were compared against those who screened positive for mania but who didn�t suffer from migraines.

Amongst males, 14.9% of those with manic episodes were also diagnosed with migraines compared with 5.8% of the general population. Amongst females, 34.7% had both migraines and bipolar disorder compared with 14.7% who only had migraines.unquote.gif

While the research was skewed towards persons who were already diagnosed with bipolar disorders, what does it mean for people who suffer from migraines but who may have an undiagnosed bipolar disorder?



Migraines and headaches aren�t fully understood but the manifestations are very real and debilitating for their sufferers:

Throbbing pain
Nausea
Heightened sensitivity to light or sound
Seeing dots, wavy lines, flashing lights, or blind spots
Difficulty with speech, sensation, or movement

 


An estimated 2.1 million American adolescents have experienced major depression within the last year, according to a new comprehensive government study.  Researchers surveyed more than 67,000 young people ages 12 to 17 and found that one in 12 had suffered from serious depression in the previous year.Nearly 13 percent of girls had struggled with depression, compared to less than 5 percent of boys. Odds of depression increased with age -- just 4 percent of 12-year-olds experienced depression but that climbed to 11 percent for older teens.

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Patient Life Charting

By Forum Admin
What is Life Charting?

A life chart is a systematic collection of retrospective (past) and prospective (current) data on the course of illness and treatment recorded by a patient and/or clinician on the retrospective (by month) and prospective (by day) Life Chart Methodology (LCM) forms.

On each life chart, the horizontal line across the middle of the chart represents the baseline (euthymia, neither depressed nor hypomanic or manic) and the dateline. Retrospective life charting is done monthly and prospective ratings are done daily. Hypomania and mania are charted above the dateline, and depression is charted below the dateline, creating a graphical picture of mood fluctuations above and below normal over time. Any hospitalization (for mood) is considered a severe episode and is completely darkened for easy recognition.

Dotted lines represent estimated episodes (unsure of date). Ultra-rapid (four or more episodes per week) or ultradian (rapid mood shifts within a day) cycling is indicated by vertical lines. Treatments, including medications and psychotherapy, are charted above the top of the mania section. Comorbid symptoms, such as alcohol and/or substance abuse, anxiety, panic attacks, and others are recorded below the depression section. Significant life events are charted below the comorbidity section with an impact rating from -4 (very negative) to +4 (very positive), with 0 representing no impact.



What is the History of Life Charting?


At the beginning of the twentieth century, the German psychiatrist Dr. Emil Kraepelin first distinguished manic-depressive (or bipolar) illness from schizophrenia. His approach to recording and delineating the course of affective illness was the basis for the National Institute of Mental Health Life Chart Methodology (NIMH-LCMâ„¢).

Dr. Kraepelin™s early life chart graphs charted episodes at monthly intervals with color codes (e.g. red for mania, lighter red for hypomania, dark and light blue for severe and mild depression, respectively). Dr. Kraepelin™s early studies found that patients often undergo a progressive increase in cycle frequency, or a decrease in the well interval between episodes; that initial episodes were often triggered by external events, but later episodes emerged spontaneously; and that affective illness tended to continue in families (genetic vulnerability).

The NIMH-LCM was developed in the 1980™s based on Dr. Kraepelin™s principles of charting the course of affective illness (Roy-Byrne et al., 1985, Acta Psychiatrica Scandinavica 71: 1“34; Post et al., 1988, Am J Psychiatry 145: 844“848). This method was then further developed, codified, and computerized (Leverich and Post, 1996, Current Review of Mood and Anxiety Disorders 1: 48“61; 1998, CNS Spectrums 3: 21“37). The availability of so many new medications and other treatments for bipolar disorder has made it more important than ever to track the course of illness and the response to treatment. The knowledge of a patient™s past course of illness, such as prior number of episodes, illness pattern, and treatment response, can have a significant impact on the choice of current and future treatment strategies.



Does Life Charting Work?

Hundreds of patients have used the NIMH-LCM successfully to keep track of their illness. Many different patterns of illness were unknown to both patients and their physicians before a life chart was constructed. The life chart also provides a portable psychiatric history for patients, useful when changing treatment providers or settings.

Is life charting accurate, however? In other words, is life charting consistent and dependable when repeated (reliability), and does it measure what it is supposed to measure (validity)?

Two different studies have confirmed both the validity and reliability of the NIMH-LCM. In 1997, Denicoff et al. (J Psychiatric Res; 31: 593“603) found that the Prospective Life Chart (LCM-p) reliability was extremely consistent between two different raters in 27 bipolar patients, over a two-week period of daily ratings by each rater. To assess validity, Denicoff et al. correlated LCM-p depression and mania ratings with other more established rating scales, such as the Hamilton Rating Scale for Depression (HRSD), the Beck Depression Inventory (BDI), the Young Mania Rating Scale (YMRS), and the Global Assessment Scale (GAS). They found statistically significant correlations between the LCM-p depression ratings and the two depression scales (HRSD and BDI), between the LCM-p mania ratings and the YMRS, and between the LCM-p average severity rating and the GAS.

In a second study (Psychological Med 2000; 30: 1391“1397), Denicoff et al. compared LCM-p ratings in 270 bipolar patients to the Inventory of Depressive Symptomatology-clinician rated (IDS-C) scale, the YMRS, and the Global Assessment of Functioning (GAF) scale. Again, the validity of the NIMH-LCM was confirmed, this time in a study with a much larger number of patients. Statistically significant correlations were found between severity of depression ratings on the LCM-p and the IDS-C, between LCM-p mania ratings and the YMRS, and between LCM-p average severity of illness ratings and the GAF.

A study of the NIMH-LCM in the Netherlands found that most of the patients found it worthwhile, and were able to complete their life charts with minimal outside assistance (Honig et al., 2001; Patient Education and Counseling 43: 43“48).
_


Patient Life Charting

Would you like to be able to keep track of all aspects of your bipolar illness on one simple form? The patient retrospective and prospective life chart forms have proven to be invaluable aids in managing bipolar illness for thousands of patients.



A. Patient Retrospective and Prospective Manuals and Forms:

"In the past you have probably been asked many questions about your illness by doctors and/or therapists who have worked with you, and by family members or friends who were concerned about your well-being. It can be difficult, however, to remember things "on the spot" and important facts could be left out that would be useful for your doctor or therapist to be aware of when trying to decide on the next step in your treatment. You already know that you benefit from being an informed and knowledgeable participant in your treatment process. We think that the life chart can be a very effective and valuable tool in helping you organize and visually present many important aspects of the past course of your illness.

"By constructing your own life chart you are creating a portable psychiatric history of your illness in the form of an easily understandable graph or picture that you and your physician can review together, change where necessary, consult when important decisions about your treatment are being made, and continue to use as a way of monitoring your current course of illness and treatment response through daily prospective life-charting."



B. Downloading Life Chart Forms and Manuals:

The patient life chart manuals and forms are in Adobe Acrobat *.pdf form. Adobe Acrobat Reader is a free program that you can download from the internet at:

ADOBE


1. Patient Retrospective Forms and Manuals:

Patient Restrospective Manual (File Size: 747 KB)

Patient Retrospective Form (File Size: 32 KB)



2. Patient Prospective Forms and Manuals:

Patient Prospective Manual (File Size: 2.06 MB)

Patient Patient Form (File Size: 31 KB)

Sources - NIMH and bipolar news.org

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Depression & Mental Health FAQs 2
What is Clinical Depression?

Clinical depression can affect your body, mood, thoughts, and behavior. It can change your eating habits, how you feel and think about things, your ability to work and study, and how you interact with people.

Clinical depression is not a passing mood, a sign of personal weakness or a condition that can be willed away. Clinically depressed people cannot "pull themselves together" and get better.

Depression can be successfully treated by a mental health professional or certain health care providers. With the right treatment, 80 percent of those who seek help get better. And many people begin to feel better in just a few weeks.

Depression a Big Factor in Poor Health
World Health Organization Finds Depression Often Goes Untreated
By Salynn Boyles
WebMD Medical News
Reviewed by Louise Chang, MD

Sept. 6, 2007 -- Depression has a greater impact on overall health than arthritis, diabetes, angina, and asthma, but it all too often goes unrecognized and untreated, a report from the World Health Organization (WHO) suggests.
more...Depression a Big Factor in Poor Health

For Additional Information About Depression Write To:
The National Institute of Mental Health (NIMH)
6001 Executive Boulevard, Room 8184, MSC 9663
Bethesda, MD 20892-9663
 

For free brochures on depression and its treatment call:  1-800-421-4211.
or visit: http://www.nimh.nih.gov
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