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Published By  Lindsay

Sometimes the health care system just does not work.


I had seen him one week earlier on a Friday afternoon, accompanied by his estranged wife. They were there because of concern about increased depression. He told me that he had stopped taking his lithium and paroxetine (Paxil) several months earlier because he felt they weren’t working. He also readily admitted to having returned to the habit of drinking one or two six-packs daily and more on weekends several months before the medications stopped working.

As the story evolved, I learned that he had stopped going to work and then was fired. He had no energy or ambition. He was not sleeping either well or regularly. This visit had been precipitated because he had gotten angry with a neighbor and tried choking him. When I asked him if he had had other times when he considered doing things that might harm others, he said that he had been driving around with his loaded gun, feeling very angry and wondering if he would feel better if he shot somebody, and whether it would be better to shoot somebody he knew or a stranger.


Published By  Lindsay

Psychologist Marc Milhander, 54, says he's weeks away of having to close his Niles, Mich., counseling center after delays and denials in insurance payments caused by an overhaul of treatment codes.

Published at 4:45 a.m. ET:


Marc Milhander conducted more than 100 psychotherapy sessions in the first few weeks of this year, treating patients ranging from the mildly anxious to the severely depressed and the 24-year-old with antisocial personality disorder who really wants to get his hands on a gun.

But Milhander, 54, a psychologist who co-owns a busy Niles, Mich., counseling center, is getting pretty anxious himself.

He’s among a growing number of U.S. mental health professionals who say their insurance claims have been denied -- and their payments have been withheld -- because of problems resulting from nationwide changes in psychotherapy treatment codes that took effect Jan. 1“I’ve been paid for five hours of work for the month of January,” said Milhander, who supports a staff of four and oversees 300 patients a month. “I just wrote a big, fat check out of my personal bank account to keep us afloat.”



Published By  Lindsay
Monday, Mar. 19, 2012


The mind, in our modern conception, is an array of circuits we can manipulate with chemicals to ease, if not cure, depression, anxiety and other disorders. Drugs like Prozac have transformed how we respond to mental illness. But while this revolution has reshaped treatments, it hasn't done much to help us diagnose what's wrong to begin with. Instead of ordering lab tests, psychiatrists usually have to size up people using subjective descriptions of the healthy vs. the afflicted.

Which is why the revision of a single book is roiling the world of mental health, pitting psychiatrists against one another in bitter debates. The book is the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short, and it is the bible of mental illness. First published in 1952, the DSM attempts to catalog every psychological problem humans experience. The new edition set to be published next year will be the first revision since 2000. It will literally redefine what's normal.

On any given day, 4.4 million Americans receive mental-health services. Patients, doctors, insurers, pharmaceutical companies and taxpayers all have a stake in how the new edition is written. For anyone feeling down or anxious, tweaks to the DSM may determine whether their symptoms are merely unpleasant or actually signs of disease. These changes will ripple through the mental-health field and affect whether and how much insurers will pay for treatment. Small wonder, then, that the production of what's being called DSM 5 is wildly controversial.


Published By  Lindsay

Research shows how to reap the benefits of self-compassion

Monday, July 16, 2012 - Being kind to yourself is a surefire way to improve your mental health and reach your goals, a growing body of work suggests. Now research has revealed an easy way to boost this self-compassion—by showing kindness to others.


Self-compassion is distinct from self-esteem, a trait that can shade into narcissism. Nor should it be confused with self-pity or self-indulgence. “Self-compassion is treating yourself with the same kindness and care you'd treat a friend,” says Kristin Neff, a professor of psychology at the University of Texas at Austin and the leading researcher in the growing field of self-compassion. People who are self-compassionate avoid harsh cri-tiques or negative generalizations of themselves, and they see their troubles as part of the human condition.


Published By  Lindsay

The Neglect of Mental Illness Exacts a Huge Toll, Human and Economic

By letting mental afflictions go untreated, we consign millions of Americans to misery and put a drag on our economy

Mental health care is one of the biggest unmet needs of our time. Nearly one in two people in the U.S. will suffer from depression, anxiety disorders or another mental health ailment at some point in their life, and about one in 17 Americans currently has a serious mental illness. Young people are especially prone to these troubles. Yet millions of people living with these conditions do not receive the care they require. In recent years the health system and state and federal governments have taken steps to right that wrong. Progress has been slow, and budget cuts and legal wrangling have now put many of these measures at risk. Doctors, insurers and politicians need to pick up the pace.


Published By  Lindsay
Some 45.9 million, or around 1 in 5 American adults (age 18 and over) experienced a mental illness in the past year, according to the US government's latest National Survey on Drug Use and Health, released this month.

The survey, published by the Substance Abuse and Mental Health Services Administration (SAMHSA), finds that the rate of mental illness among 18 to 25-year-olds was more than twice as high as among people aged 50 and over (29.9% versus 14.3% respectively).
The survey report defines mental illness as having a diagnosable mental, behavioral or emotional disorder based on criteria given in DSM-IV (the Diagnostic and Statistical Manual of Mental Disorders edition IV, published by the American Psychiatric Association, APA, in 1994). The definition excludes developmental and substance use disorders.


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