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7 Myths Of Depression


By John M Grohol PsyD
October 18, 2009


Depression is often viewed as the “common cold” of mental disorders, because it is so prevalent in our lives. The lifetime prevalence of depression suggests that more than 1 in 9 people could be diagnosed with the disorder at one point in their lives. And unlike some other mental disorders, depression affects virtually every aspect of what you do and how you interact with others. Every year, it wreaks havoc in millions of Americans’ lives, especially amongst those who believe it is something you should just “get over” on your own.


Here are seven common myths about depression, and the facts that answer them.


1. Depression means I’m really “crazy” or just weak.


While depression is indeed a serious mental disorder, it is no more serious than most other mental disorders. Having a mental disorder doesn’t mean you’re “crazy,” it just means you have a concern that is negatively impacting how you live your life. Left unaddressed, this concern can cause a person significant distress and problems in their relationships and life. Depression can strike anyone, at any time — whether you’re “weak” or strong, it knows no bounds. Some of the strongest people I’ve met are people who’ve coped with depression in their lives.


2. Depression is a medical disease, just like diabetes.


While some pharmaceutical-influenced marketing propaganda might simplify depression into a medical disease, depression is not — according to our knowledge and science at this time — simply a pure medical disease. It is a complex disorder (called a mental disorder or mental illness ) that reflects its basis in psychological, social, and biological roots. While it has neurobiological components, it is no more of a pure medical disease than ADHD or any other mental disorder. Treatment of depression that focuses solely on its medical or physical components — e.g., through medications alone — often results in failure. Get to know the risk factors for depression.


3. Depression is just an extreme form of sadness or grief.


In most cases, depression is not just ordinary sadness or grief over a loss. If it were ordinary sadness or grief, most people would feel better just over time. In depression, time alone doesn’t help, nor does willpower (”Pull yourself up and stop feeling so sorry for yourself!”). Depression is overwhelming feelings of sadness and hopelessness, every day, for no reason whatsoever. Most people with depression have little or no motivation, nor energy and have serious problems sleeping. And it’s just not for one day — it’s for weeks or months on end, with no end in sight.


4. Depression just affects old people, losers and women.


Depression — like all mental disorders — does not discriminate based upon age, gender, or personality. While generally more women than men are diagnosed with depression, men suffer for it all the more since many people in society believe that men shouldn’t show signs of weakness (even a man’s own upbringing may reinforce such messages). And while aging brings many changes in our life, depression is not a normal part of the aging process. In fact, teenagers and young adults grapple with depression just as much as seniors do. Some of the world’s most successful people have also had to deal with depression, people such as Abraham Lincoln, Theodore Roosevelt, Winston Churchill, George Patton, Sir Isaac Newton, Stephen Hawking, Charles Darwin, J.P. Morgan and Michelangelo. So being a loser is not a prerequisite to being depressed.


Read More:  http://psychcentral.com/blog/archives/2009/10/18/7-myths-of-depression/



The birth of the ‘psychic energizer’:


With uncanny echoes of the modern interest in ‘cognitive enhancers’, a 1958 edition of Popular Science hails a new drug that “tunes up the brain” allowing us “to perform at peak efficiency all the time”.


The drug is iproniazid, marketed then as Marsilid. It was the first ever antidepressant, but the concept of an ‘antidepressant’ had yet to be created by the pharmaceutical companies and instead it is described as ‘psychic energizer’.


It was originally used a treatment for tuberculosis, as it stops the bacterial infection, but it was noticed that patients treated with iproniazid seemed to have a lift in mood at low doses and risked becoming confused and psychotic at higher doses.


At the time, the only widely used psychiatric drugs were tranquilisers, and the idea that a drug might be an ‘anti-tranquiliser’ was quite puzzling. It was trialled on some patients with diagnoses of mental illness patients and then marketed as a ‘psychic energizer’.


Read in Full:  http://www.mindhacks.com/blog/2009/10/the_birth_of_the_ps.html



Omega-3 supplements fail to improve antidepressant effectiveness in heart patients


Jim Dryden – JAMA


Contrary to the findings of some studies, new research indicates that augmenting antidepressant therapy with an omega-3 fatty acid supplement does not result in improvement in levels of depression in patients with coronary heart disease, according to a study in the October 21 issue of JAMA.


Low dietary intake and low serum or red blood cell levels of omega-3 fatty acids are associated with depression in patients with and without coronary heart disease (CHD) and with an increased risk for cardiac mortality,” according to background information in the article. “In depressed psychiatric patients who are otherwise medically well, some studies have indicated that augmentation with omega-3 fatty acids dramatically improves the efficacy of antidepressants.


Robert M. Carney, PhD, of Washington University School of Medicine, St. Louis, and colleagues conducted a randomized, placebo-controlled trial to examine whether omega-3 improves the efficacy of the antidepression medication sertraline for patients with CHD and major depression. The study included 122 patients, who received 50 mg/day of sertraline and were randomized to receive 2 g/day of omega-3 acid ethyl esters (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) (n=62) or placebo capsules (n=60) for 10 weeks. Depression was gauged via scores on the Beck Depression Inventory (BDI-II) and the Hamilton Rating Scale for Depression (HAM-D). Adherence to the medication regimen was at least 97 percent in both groups for both medications.


The researchers found that there was no difference in improvement between groups on the Beck Depression Inventory. In both groups, estimated weekly Beck Depression Inventory scores showed that depressive symptoms improved over time at comparable rates. The placebo and omega-3 groups did not differ at 10 weeks in regard to measurements of depression or anxiety. There was no significant difference in rates of remission or treatment response between the two groups.


Whether higher doses of EPA, DHA, or sertraline, a longer duration of treatment, or the use of omega-3 as monotherapy can improve depression in patients with stable heart disease remains to be determined,” the authors conclude.


Carney RM, Freedland KE, Rubin EH, et al. Omega-3 Augmentation of Sertraline in Treatment of Depression in Patients With Coronary Heart Disease A Randomized Controlled Trial. JAMA. 2009;302(15):1651-1657   [Abstract]



Rexahn Reports Positive Top-line Phase IIa Data For SerdaxinTM In Patients With Major Depressive Disorder (MDD)


Article Date: 21 Oct 2009 – 1:00 PDT


Rexahn Pharmaceuticals, Inc. (NYSE Amex: RNN), a clinical stage biopharmaceutical company focused on developing multi-indication therapeutics in CNS and oncology, announced top-line results from a Phase IIa clinical study of Serdaxin™, its major depressive disorder (MDD) drug candidate.


The randomized, double blind, placebo controlled and dose ranging study enrolled 77 patients and was conducted at multiple sites in the United States to assess the Serdaxin’s safety and preliminary efficacy. The study showed that patients ages 18-65 with MDD exhibited clinically meaningful improvement over baseline in symptoms of depression as measured by the Montgomery-Asberg Depression Rating Scale (MADRS) total score. A marked clinical response was observed within two weeks in patients taking Serdaxin. Additionally, a significantly lower drop-out rate among patients taking Serdaxin compared with those patients taking a placebo was observed (<20% treatment groups vs. >50% placebo group).


Commenting on the findings, Dr. Robert A. Riesenberg, a nationally recognized psychiatrist and principal investigator at the Atlanta Center for Medical Research, said, “The wide range and consistency of Serdaxin’s effects in this study suggests a new treatment paradigm for patients suffering from depression.”


Dr. Riesenberg added, “Serdaxin exhibited an onset of action in fewer than two weeks, and was found to be safe and well tolerated with no appearance of serious side effects commonly linked to currently marketed antidepressant drugs.”


“Serdaxin clinical trials continue to demonstrate unprecedented efficacy, much faster onset of action compared to currently marketed drugs, and lifestyle benefits for patients with major depressive disorder,” said Dr. Chang Ahn, Rexahn’s Chairman and Chief Executive Officer. “The continued strength of Serdaxin’s clinical trial data further solidifies Serdaxin as a potentially new and preferable therapy in the standard of care for this disease.”


Rexahn is currently in active discussions with multiple pharmaceutical companies with the goal of identifying a strategic partner to assist in the global development and planned commercialization of Serdaxin. Rexahn expects Phase IIb clinical development to be initiated in early 2010.


Read in Full:  http://www.medicalnewstoday.com/articles/168065.php


Blue Angel

Antidepressants on trial: How valid is the evidence?


Parker G.


Scientia Professor of Psychiatry, University of South Wales;
Executive Director, Black Dog Institute, Sydney


Clinicians and researchers have been trying for decades to determine if there are differences in efficacy among antidepressants. According to Dr Gordon Parker, the key problems leading to contradictory or inconclusive results stem from how we define “depression” and from randomized-controlled-trial (RCT) practices.


If we examine meta-analyses from RCTs (and these represent the largest database that we have in psychiatry), then we see clear treatment equivalence in that all antidepressant classes have very similar responder rates,” says Dr Parker. “In fact, the rates compare with those derived from RCTs of cognitive behavior therapy and interpersonal psychotherapy. Of greater concern is that such RCT data generally demonstrate that the responder rates for these differing antidepressant classes do not differentiate very much from responder rates in those receiving placebo. For the evidence-based psychotherapies, a similar story is evident in the literature in that they also do not differ from credible placebos.


More…



© 2009 Psychiatry Weekly, LLC


Traumatic Childhood

A traumatic childhood may wipe decades off lifespan


By Patricia McAdams, HBNS Contributing Writer


Many U.S. children face a terrible burden of stressors that can harm the development of their brains and nervous systems. These stressors can lead to health problems and diseases throughout their lives, ultimately causing some to die prematurely, according to the lead author of a new study.


David W. Brown, DSc, an epidemiologist at the Centers for Disease Control and Prevention (CDC), and colleagues found that children who were exposed to six or more “adverse childhood experiences” or ACEs were at double the risk of premature death compared to children who had not suffered these experiences.


On average, the children at highest risk eventually died at age 60, compared to low-risk children who lived to age 79.


The study appears in the November issue of the American Journal of Preventive Medicine.


Conducted by Kaiser Permanente in San Diego and the CDC, the study looked at the long-term effects of these childhood experiences: undergoing verbal or physical abuse, having a battered mother and witnessing domestic violence, living in a household with substance abuse or mental illness, having an incarcerated household member or having parents who separated or divorced.


Data came from 17,337 adults who visited Kaiser Permanente from 1995 to 1997 and completed a standardized medical questionnaire that included questions about their childhood. Researchers followed participants through the end of 2006, using the National Death Index to discover who had died.


Overall, 1,539 people died during follow-up,” Brown said. “People with six or more ACEs died nearly 20 years earlier on average than those without ACEs. It is also disturbing that two-thirds of study participants – persons who were relatively well off – had at least one of the ACEs.


The database of the Adverse Childhood Experiences study, utilized in this issue by Dr Brown and his colleagues to demonstrate the link between childhood adversity and premature death, may ultimately provide us with most important public health data ever compiled,” said Sandra L. Bloom, MD, an associate professor of health management and policy at Drexel University School of Public Health.


Our hope is that, as a result of this research, child maltreatment and exposure to childhood traumatic stress in its various forms will be more widely recognized as a public health problem,” Brown said. “It is important to understand that consequences to childhood trauma can extend over an individual’s life.


Brown DW, Anda RF, Tiemeier H, et al. Adverse Childhood Experiences and the Risk of Premature Mortality. Am J Prev Med 2009 Nov; 37(5):89-396   [Abstract]


Neurotransmitters

New Discovery May Aid Depression Treatment


By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on October 20, 2009


A new research studies illuminates how our body regulates neurotransmitters, the chemicals that relay, amplify, and modulate signals between nerve cells.


Neurotransmitters include norepinephrine, serotonin, and dopamine. Current drug treatments for depression target the regulatory process for neurotransmitters. While these are effective in some cases, they do not always work.


Recent findings suggest that synucleins, a family of small proteins in the brain, are key players in the management of neurotransmitters — specifically, alpha- and gamma-synuclein.


Additionally, researchers have found elevated levels of gamma-synuclein in the brains of both depressed animals and humans.


In a study presented at the 39th annual meeting of the Society for Neuroscience, Georgetown University Medical Center researchers observed increased depressive-like behavior in mice where gamma-synuclein acts alone to regulate neurotransmitters, confirming earlier studies by this group.


Read in Full:  http://psychcentral.com/news/2009/10/20/new-discovery-may-aid-depression-treatment/9056.html


ECG

An ECG For Depression?


By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on October 16, 2009


Everyone is aware of the tremendous value an electrocardiogram conveys by giving a snapshot of cardiac activity. What if a similar tool could be used to assess brain function and allow quick detection of mental and neurological illness?


According to a Monash University biomedical engineer, a device to detect and compare the brain’s normal electrical activity against the distinct electrical patterns found in depression, schizophrenia and other central nervous system (CNS) disorders is right around the corner.


Brian Lithgow has developed electrovestibulography which is something akin to an ‘ECG for the mind.’ Patterns of electrical activity in the brain’s vestibular (or balance) system are measured against distinct response patterns found in mental disorders.


Working with psychiatry researchers at Monash University’s Alfred Psychiatry Research Centre (MAPrc) in Melbourne, Australia, he tested volunteers and found distinct response patterns, or “biomarkers,” that distinguished different CNS diseases from each other and from regular electrovestibular activity.


Monash has teamed up with corporate partner Neural Diagnostics to develop and patent electrovestibulography, or EVestG™. It is hoped the simple, quick and inexpensive screening process for CNS diseases will eventually become standard practice in hospitals around the world.


Read in Full:  http://psychcentral.com/news/2009/10/16/an-ecg-for-depression/9011.html



Tricyclic Antidepressant May Increase Suicidal Thoughts In Men


By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on October 16, 2009


A new report states that nortriptyline, a second-generation tricyclic antidepressant has been found to cause a tenfold increase in suicidal thoughts in men when compared to an antidepressant that works as a selective serotonin reuptake inhibitor (SSRI).


Nortriptyline is marketed as Pamelor, or Aventyl HCl . Researchers compared nortriptyline to escitalopram (Lexapro, or Cipralex) and discovered the increased risk of suicidal ideation.


These findings are published in the open access journal BMC Medicine.


The research was carried out by Dr. Nader Perroud from the Institute of Psychiatry, Kings College London, who headed up GENDEP, an international team.


Dr. Perroud said “Suicidal thoughts and behaviors during antidepressant treatment have prompted warnings by regulatory bodies. The aim of our study was to investigate the emergence and worsening of suicidal thoughts during treatment with two different types of antidepressant.”


Both escitalopram and nortriptyline have their effect through the mood modulating neurotransmitter systems. The former is a selective serotonin reuptake inhibitor (SSRI), preventing serotonin from re-entering the cell and thereby prolonging its effect on nerve synapses.


The latter is a tricyclic antidepressant that inhibits the reuptake of noradrenaline, and to a lesser extent, that of serotonin.


The study was carried out on 811 individuals with moderate to severe unipolar depression.




For SAD Sufferers, Cognitive Behavior Better Than Light Therapy At Preventing Recurrence, Study Suggests


ScienceDaily (Oct. 17, 2009) — In the September issue of the journal Behavior Therapy, University of Vermont psychologist Kelly Rohan presents the first published research study of the long-term effects of different treatments for seasonal affective disorder (SAD), a form of severe depression that occurs annually in the fall and winter seasons. The first year Rohan randomized 69 people with SAD into one of four groups: light therapy treatment, cognitive behavior therapy (CBT), a combination of the two or a wait-list control. She then surveyed participants on how they were doing the next winter – one year later.


Of those treated with CBT, only 7 percent had a recurrence compared to 36.7 percent of people treated with light therapy. The recurrence rate for the combination group was 5.5 percent. When Rohan looked at the severity of the depression that did occur, however, CBT was associated with less severe depression than those treated with either light therapy or a combination of both.


In a previous study that measured the acute affects of each treatment (immediately following six weeks of intervention), combination therapy was highly effective, with a nearly 80 percent remission rate compared to 50 percent for both CBT and light therapy alone and 20 percent on the wait-list.


Read in Full:  http://www.sciencedaily.com/releases/2009/10/091016163659.htm


Medical Foods

Treating Depression and Folate Deficiency With Medical Foods

By Alicia Sparks

Midweek Mental Greening

First and foremost, I should offer a disclaimer for this post:


The scientific media briefing I watched this morning, “Feeding the Brain to Help Manage Depression: The Role of Medical Foods,” was presented by Rakesh Jain, M.D., M.P.H., the Director of Psychiatric Drug Research at R/D Clinical Research Center in Lake Jackson, TX and Teodoro Bottiglieri, Ph.D. of the Baylor Institute of Metabolic Disease, and sponsored by Pamlab, a pharmaceutical company specializing in prescription medical foods. Neither PsychCentral.com nor myself is affiliated with Pamlab or Deplin, the new medical food discussed during the briefing.


Now that that’s out of the way, on to the more interesting stuff.


“Can we feed the brain to regulate mood disorders?”


If you had no experience with or knowledge of medical foods (meant for nutritional or dietary management of specific diseases), you might’ve thought Jain and Bottiglieri were referring to feeding the brain – and our bodies – with actual food when you heard that question.


Instead, the men were referring to medical foods – more specifically, a new product called Deplin, a medical food that includes L-methylfolate, the only active form of folate that can cross the blood brain barrier and help with the synthesis of the neurotransmitters associated with mood and, consequently, mood disorders such as depression: serotonin, dopamine, and norepinephrine.


Research shows that people with depression and low folate levels are less likely to respond to treatments such as antidepressants and less likely to achieve remission.


(Unfortunately, a smorgasbord of factors can contribute to low folate levels – genetics, age, lifestyle choices like poor diets and smoking, certain medications like anticonvulsants, oral contraceptives, and lithium, and certain illnesses like Crohn’s disease, hypothyroidism, and diabetes, just to name a few.)


Read More:  http://psychcentral.com/blog/archives/2009/10/15/treating-depression-and-folate-deficiency-with-medical-foods/



Green spaces ‘improve health’


There is more evidence that living near a ‘green space’ has health benefits.


Research in the Journal of Epidemiology and Community Health says the impact is particularly noticeable in reducing rates of mental ill health.


The annual rates of 15 out of 24 major physical diseases were also significantly lower among those living closer to green spaces.


One environmental expert said the study confirmed that green spaces create ‘oases’ of improved health around them.


The researchers from the VU University Medical Centre in Amsterdam looked at the health records of 350,000 people registered with 195 family doctors across the Netherlands.


Only people who had been registered with their GP for longer than 12 months were included because the study assumed this was the minimum amount of time people would have to live in an environment before any effect of it would be noticeable.


Health impact


The percentages of green space within a one and three kilometre (0.62 and 1.86 miles) radius of their home were calculated using their postcode.


On average, green space accounted for 42% of the residential area within one kilometre (0.62 miles) radius and almost 61% within a three kilometre (1.86 miles) radius of people’s homes.


And the annual rates for 24 diseases in 7 different categories were calculated.


The health benefits for most of the diseases were only seen when the greenery was within a one kilometre ( 0.62 miles ) radius of the home.


The exceptions to this were anxiety disorders, infectious diseases of the digestive system and medically unexplained physical symptoms which were seen to benefit even when the green spaces were within three kilometres of the home.


The biggest impact was on anxiety disorders and depression.


DISEASES THAT BENEFIT MOST FROM GREEN SPACES
Coronary heart disease
Neck, shoulder, back, wrist and hand complaints
Depression and anxiety
Diabetes
Respiratory infections and asthma
Migraine and vertigo
Stomach bugs and urinary tract infections
Unexplained physical symptoms

Anxiety disorders


The annual prevalence of anxiety disorders for those living in a residential area containing 10% of green space within a one kilometre (0.62 miles) radius of their home was 26 per 1000 whereas for those living in an area containing 90% of green space it was 18 per 1000.


For depression the rates were 32 per 1000 for the people in the more built up areas and 24 per 1000 for those in the greener areas.


Read More:  http://news.bbc.co.uk/1/hi/health/8307024.stm



Disposal by Flushing of Certain Unused Medicines: What You Should Know


 

 

 

Medicines play an important role in treating certain conditions and diseases, but they must be taken with care. Unused portions of these medicines must be disposed of properly to avoid harm. Almost all medicines can be thrown away in the household trash after mixing them with some unpalatable substance (e.g., coffee grounds) and sealing them in a container.


However, certain medicines may be especially harmful and, in some cases, fatal in a single dose if they are used by someone other than the person the medicine was prescribed for. For this reason, a few medicines have special disposal directions that indicate they should be flushed down the sink or toilet after the medicine is no longer needed. If you dispose of these medicines down the sink or toilet, they cannot be accidently used by children, pets, or anybody else.


You may have also received disposal directions for these medicines when you picked up your prescription. If your medicine is on this list, and you did not receive information on disposal with your prescription, you can find directions on how to dispose of the medicines at DailyMed. After you search on the drug name, the disposal information for these medicines can be found in one of the following sections of the prescribing information:


  • *Information for Patients and Caregivers
  • *Patient Information
  • *Patient Counseling Information
  • *Safety and Handling Instructions
  • *Medication Guide

 

 

It is important to note that disposal by flushing is not recommended for the vast majority of medicines. Unused or expired medicines that do not have flushing directions in the label can be disposed of safely in the household trash by:


  1. 1.  Mixing them with something that will hide the medicine or make it unappealing, such as kitty litter or used coffee grounds.
  2. 2.  Placing the mixture in a container such as a sealed plastic bag.
  3. 3.  Throwing the container in your household trash.

 

 

Below is some additional information about the disposal of medicine that is no longer needed. If you have additional questions about disposing of your medicine, please contact us at 1-888-INFO-FDA (1-888-463-6332).

 

Read More(Includes FAQ & Meds Recommended For Disposal By Flushing):  http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm



If Herbal Medicine is Medicine, Shouldn’t it be Treated as Such?


By Rachel Danks, PhD


Recently, the UK Government announced a consultation on whether practitioners of acupuncture, herbal medicine and traditional Chinese medicine should become subject to statutory regulation. Unsurprisingly, the announcement has sparked some lively debate. Currently, most herbal remedies and dietary supplements are classified by regulatory authorities as “foods,” and therefore subject to far less stringent legal requirements than pharmaceutical products. However, if a herbal remedy offers some pharmacological effect over and above its nutritional value (and many undoubtedly do), then it becomes no longer a food but a medicine.


Medicines, including herbal medicines, make changes at a physiological level. Some of these changes are desirable and some are not. It would be irrational to imagine that any agent would have only positive benefits: if you believe an effect is real enough to do you good, you must also believe it could do you harm. The secret of good medicine is to balance the potential benefits of a drug with its known side effects.


There is a widespread perception that a herbal remedy is somehow more gentle or less ‘alien’ than a prescription drug. In fact, herbal medicines are generally no more than plant extracts containing an assortment chemicals whose actions are largely unknown. Is it really better to swallow a jumble of plant chemicals than a single, purified and identifiable one? With a prescription or over-the-counter drug, at least you know what you are getting; a herbal remedy, by contrast, can vary from one country to another, one manufacturer to another or even one bottle to another. In fact, analyses have revealed that the contents of many herbal products do not always match the ingredients listed on the labels, and some even contain dangerous poisons, including pesticides, lead or mercury. It is ironic that so many people who are so particular about what they consume are prepared to take tablets they so little about.


Despite the advances made in conventional medicines, many people live their lives in constant pain and discomfort, and are willing, or desperate, to give anything a try. It is these people more than most who must be protected from the false hopes and exaggerated claims that some herbal remedies offer.


Read in Full:  http://brainblogger.com/2009/10/16/if-herbal-medicine-is-medicine-shouldnt-it-be-treated-as-such/



Your Patient Rights In Therapy


By John M Grohol PsyD


Before you go into psychotherapy, you should be informed of your rights as a patient ahead of time by the therapist. The therapist should, in addition, give you a printed copy of something that reads similar to the below, so that you can take it home with you. We’ve long had a version of these rights here on our website, but I thought it might be helpful to further describe or explain each right in a little more detail.


Therapists nowadays may also often offer you their guidelines for electronic and/or outside contact, (such as through Facebook, email, telephone, etc). This sets the ground rules for how you may contact the therapist outside of session, in event of an emergency, or in the event that you just want to share something with your therapist (or change your appointment or such).


You should know that these rights are not absolutes, and there may be exceptions based upon what kind of treatment you’re undertaking, under what conditions, and in what country or province you live in (even state laws vary that may alter some of these rights). If you have a specific concern with one of these rights, you should discuss it with your therapist during your next session.


Your Patient Rights in Psychotherapy


Every patient engaging in psychotherapy with a professional has the following rights:


  • *You have a right to participate in developing an individual plan of treatment.

  • Every client in psychotherapy should have a treatment plan that describes general goals of therapy, and specific objectives the client will work on in order to achieve their goals. Without such a plan, how would you know you’ve made progress?

  • *You have a right to receive an explanation of services in accordance with the treatment plan.

  • The therapist should describe the process of how they work with clients, in as much detail as you prefer and time allows.

  • *You have a right to participate voluntarily in and to consent to treatment.

  • You are there voluntarily and should understand and consent to all treatment provided you (unless you have been court-ordered or have other state-imposed restrictions).

  • *You have a right to object to, or terminate, treatment.

  • Don’t like therapy or a specific type of treatment? You can leave at any time without any kind of repercussions (unless you have been court-ordered to attend therapy).

  • *You have a right to have access to one’s records.

  • Yes, although many professionals don’t like it, you have a right to review the records they keep on you.

  • *You have a right to receive clinically appropriate care and treatment that is suited to their needs and skillfully, safely, and humanely administered with full respect for their dignity and personal integrity.

  • Your therapist should be skilled and trained to administer the treatment he or she said they would, and do so in a dignified and humane manner. You should never feel unsafe in your therapist’s presence.



9 Types Of Hopelessness and How To Overcome Them

By Therese J. Borchard

I’ve become increasingly intrigued by the topic of hope because, if anything is going to help me climb out of the Black Hole of depression, it’s a sense of hope. In their book, “Hope in the Age of Anxiety,” psychology professors Anthony Scioli and Henry Biller discuss hope from a variety of different perspectives, combining psychology with philosophy, biology, anthropology as well as the literary classics.

I went straight to chapter thirteen, of course, and read “Overcoming Hopelessness: Escape from Darkness.” The authors argue that there are nine forms of hopelessness, each related to the disruption of one or more of the basic needs that comprise hope; attachment, mastery, or survival. The authors present three “pure forms” of hopelessness resulting from breakdowns in one of these three needs or “motive systems” (alienation, powerlessness, doom). There are also six “blended” forms of hopelessness which results when two needs are challenged. We can overcome hopelessness by first recognizing which of these nine types we are confronting. For each form of hopelessness, they present a mind-body-spirit treatment cocktail, involving a restructuring of thoughts, accessing the right kind of hope-sustaining relationship, and specific spiritual practices. Armed with these prescriptions we can summon the light back into our lives.


Here are the nine types of hopelessness and just some of the strategies recommended by Scioli and Biller. For the whole treatment package, consider getting your own copy of “Hope in the Age of Anxiety.


1. Alienation (Attachment)


Alienated individuals believe that they are somehow different. Moreover, they feel as if they have been cut loose, no longer deemed worthy of love, care, or support. In turn, the alienated tend to close themselves off, fearing further pain and rejection.



2. Forsakenness (Attachment and Survival)


The word “forsaken” refers to an experience of total abandonment that leaves individuals feeling alone in their time of greatest need. Recall Job in the Old Testament, crumpled over and covered with sores, pleading with a seemingly indifferent God.


3. Uninspired (Attachment and Mastery)


Feeling uninspired can be especially difficult for members of underprivileged minorities, for whom opportunities for growth and positive role models within the group may be either lacking or undervalued.


4. Powerlessness (Mastery)


Individuals of every age need to believe that they can author the story of their life. When that need is thwarted, when one feels incapable of navigating one’s way toward desired goals, a feeling of powerlessness can set in.



5. Oppression (Mastery and Attachment)


Oppression involves the subjugation of a person or group…. The word “oppressed” comes from Latin, to “press down,” and its synonym, “down-trodden,” suggests a sense of being “crushed under” or “flattened.”



Hope Floats

New Brain Stimulation Treatment May Offer Hope For Those With Treatment Resistant Depression


A new neurosurgical procedure may prove helpful for patients with treatment-resistant depression. Bilateral epidural prefrontal cortical stimulation (EpCS) was found generally safe and provided significant improvement of depressive symptoms in a small group of patients, according to lead researcher Ziad Nahas, M.D. at the Medical University of South Carolina. The data are reported in the on-line issue of Biological Psychiatry.


Treatment-resistant depression is a recurrent psychiatric illness and a leading cause of premature morality due to suicide and associated medical conditions. In the U.S., more than 3.2 million patients are diagnosed with treatment-resistant depression. Typically, patients have tried several medications and treatments without success or improvement.


Read More:  http://www.medicalnewstoday.com/articles/167236.php



New Program Helps Mental Health Patients Stop Smoking


By Rick Nauert PhD Senior News Editor


Experts say that tobacco use among mental health patients account for nearly half of all cigarettes consumed in the United States.


A program developed by the division of addiction psychiatry at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School to address this addiction has received national recognition by the American Psychiatric Association (APA).


The program, called CHOICES – Consumers Helping Others Improve Their Condition by Ending Smoking – utilizes peer counselors to promote smoking cessation in mentally ill patients.


The counselors, who receive 30 hours of intensive training, are nonsmokers or former smokers who are moderately impaired or disabled by mental illness.


Their goal is not to provide treatment, but to assist smoking patients who are in mental health centers, psychiatric hospitals, group homes and self-help centers, by linking them to treatment, referrals, advocacy and support for smoking cessation in New Jersey.


“Peers are less threatening than professionals,” said Jill Williams, MD, associate professor of psychiatry at Robert Wood Johnson Medical School and co-founder and medical director of the program.


“CHOICES symbolizes empowerment and personal choice in recovery by involving persons with mental illness talking with peers with mental illness who smoke, and who may have low motivation to address their tobacco use.”


A salient feature of the CHOICES program is the unique peer-to-peer approach to promoting tobacco cessation.


In the October issue of its journal Psychiatric Services, the APA said, “The CHOICES program exemplifies many aspects of a successful wellness and recovery initiative. For example, it targets a group with a vital health care need; seeks to reduce tobacco’s harm in a vulnerable group; focuses its efforts in the community, which best accommodates the target population; employs peers to reduce educational and cultural barriers; and develops successful partnerships with key stakeholders for sustainability.”


According to Dr. Williams and co-founder Marie Verna, the program’s advocacy director and senior training and consultation specialist at UMDNJ-University Behavioral HealthCare’s Center for Excellence in Psychiatry, the CHOICES team has conducted more than 280 community visits, reaching more than 9,600 smokers with mental illness, since the program’s inception in 2005. The team also visits consumer conferences and health-related fairs.


An outcome study of the program showed success at reducing the number of cigarettes smoked by consumers each day and an increase in the number of quit attempts following individualized intervention.


Read More:  http://psychcentral.com/news/2009/10/12/new-program-helps-mental-health-patients-stop-smoking/8903.html





Teaching 9-year-olds about mental illness


Oliver Moore


People with symptoms of mental illness often wait years before seeking treatment. And by the time they do, some will have the odds stacked against them because of the related effects of their disorder: substance abuse, reduced employment options and broken relationships with friends and family.


It’s a vicious pattern that the Nova Scotia government is hoping to break by offering even the youngest students specific education in mental health.


More…



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6 Steps to Quiet The Mind

By Therese J. Borchard

I was all set to interview Eric Swanson, coauthor (with Yongey Mingur Rinpoche) of “Joyful Wisdom: Embracing Change and Find Freedom,” when I realized that my main question — Can you give me some concrete steps to quiet the mind? — was already addressed in his book! So he and Harmony Books graciously gave me permission to reprint parts of chapter seven on “Attention.” Here, then, is the step-by-step approach to mindfulness or meditation — the basic practices of quieting the mind — provided in “Joyful Wisdom”:






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