Christmas day was pretty much what I expected it to be like. It was quiet with just me and Dad. I made Christmas dinner for the second year running and between us both we kept it simple, neither of us talked about mum but if my own thoughts were anything to go by I am sure dad thought about her as much as I did.

(Warning parts of this post mentions self harm)

I think I have managed to cope quite well over the Christmas period. I’m still here so that’s something to report on. I am not going to deny that suicidal thoughts have been quite prominent in my head this past few weeks, but my future plans and my extended family like my Auntie, Cousins and Godmother are keeping me going with there support and the fact I have come so far in six months is stopping me from doing anything really stupid. The bad points for me are that I self harmed on Christmas day as a way to deal with my emotions and the pain of missing mum. I was drunk and the self harm was pretty bad for me as well, superficial so I could deal with it, but the kind in which it’s going to be hard to hide for some weeks still at least it’s winter and long sleeves are the norm.

In fact for me it’s been the worse self harm I have done to myself in about a two year period, but I have repeatedly now told myself how I have managed to get to almost six months beofre without doing it and I can reach that again so I’ve now thrown away my little box of self harming tools, the things I cling onto the blades being the hardest to remove from my life. How stupid is it to have a little box of self harming tools, blades, antiseptic, gauze, bandages. Call this an early new year’s resolution this self harming lark only started again because of certain stresses that started in college recently and it continued I think as a way to deal with the impending Christmas depression but it has to stop. I’ve stopped it before and I can stop it again. It has to be taken one day at a time, but if I don’t have blades in the house it makes it more difficult to self harm doesn’t it?

I am not too proud of the amount of drinking I did over Christmas neither. I feel the self harming wouldn’t have been to such an extent if I hadn’t consumed as much vodka as I had between Christmas Eve and 7am on Boxing Day when I eventually went to bed. The strange thing is alcohol doesn’t seem to affect me like it once did, I should have had a hangover to have knocked me out for days with the amount I drank but it didn’t in fact it had little effect on me at all. I vowed I wouldn’t drink again, and then less than two hours ago I find myself shopping online at Tesco buying yet more Vodka so I can binge drink again. I think back to group therapy and J who had a serious problem with drinking and the words she use to repeat frequently ‘If I don’t stop drinking it will kill me’, I don’t want to find myself falling into that trap and I realise how easy it would be to let my emotions float into a bottle rather than deal with them properly. I cancelled the order at Tesco before it had time to be processed.

I have a lot to talk to Dr G about at my next appointment which seems so far off but I am thinking it might be wise to bring the appointment forward rather than wait till the end of January. I think I was hoping for too much of a miracle that all would be so perfect between my last appointment and the end of January.

I also mentioned on a few tweets which I swiftly deleted when I realised what I had written (the things we do when we are drunk, but some of you noticed and commented!) about L1, sadly she is still in my thoughts rather frequently a little too much. Despite the last four Psychotherapy sessions in October and November and me linking her with the whole transference issue to an old friend she is still someone I am thinking about a lot. It’s been extremely difficult since those therapy sessions ended because it brought back a whole bunch of feelings not just for her but also for the old friend I talked about – sometimes therapy does more harm than good doesn’t it. It’s adding to the intense fear of university choices because of where she is based now which is of course where I desperately want to go to study (I still feel this was too ironic and a cruel twist of fate) and have always wanted to go and truthfully it’s making me want to just runaway and hide, and if that’s sounds bloody stupid then so be it. Maybe that is what having feelings for someone is all about but how am I suppose to get over having feelings my Psychologist even if I have not seen her in over seven months.

Since March of 2000, (www.eTherapistsOnline.com) we have been

Online therapy is a new way to see a therapist

providing to the public a pool of well qualified clinicians; mental health professionals who have at least 10 years post graduate experience, provided 6 personal and professional references that attest to their qualifications, “exhibited strong professional skills including a personal interview with a top clinician and management of our company, and in general have made it though the most rigorous screening process of any online therapy site we know of.

It has been extraordinarily rewarding to watch our “experiment” in online therapy grow at a rate we’d never dreamed would happen to where we are now one of the oldest, most established and most publicized online therapy sites online today.

We have conducted a few surveys with our clients over the years, but our most recent one is the one I find most interesting, at least right now. We asked our clients what were the top five reasons they shoes online therapy over seeing someone in office and feel the results are so interesting we wanted to share them with you.

Our research was informal and consistent only of a follow up email to 200 past clients who had purchased a session for the first time within the last 6 months asking them to share with us the top 5 reasons for selecting online therapy.

The results are as follows:

# 5:  Availability — People cited that the therapist they wanted to see was available within the next 2 – 5 days as a reason for seeing someone online. Their comments indicated that this window of time, 2 – 5 days was extremely important and they felt that contact with a professional was more important than where the contact took place.

#4:  Ease of Use — respondents cited the ease of use of the site as the 4th top reason to select online therapy vs. in office therapy.  A frequent remark was that there was little effort to “sell” them on this form of therapy which they liked “Lack of pressure to buy” something was a typical response from respondents.

#3:  Price– The cost of sessions was reason number three given. They thought the range of prices from ($39.95 for 1 email to $85 for 1 60 minute chat or phone) was affordable enough to see if this would be a helpful way of “seeing “ someone and over 72% said they purchased an additional session even though we did not ask for this information.

#2:  Intake Process – While many people complained that the intake process was long, they also felt reassurance that this was “a legitimate” site; “real professionals” and “ethical licensed professionals” if they were asking this much detailed information beforehand.  Credibility, while not using that term, seemed to be the reason they were identifying.

#1:  Skill level of the professional – We post an extensive biography of each therapist on the site and the fact that qualifications was cited was not surprising to us, al thought it was surprising that it was the number one reason.  Because most of our professionals have at least 15 – 20 years post graduate experience and they write well (as demonstrated in their bio) seems to be an important indicator for those seeking therapy. This lends support to my belief that clients who seek therapy online tend to be more professional, highly educated group of people who are looking for convenience and quality in making a decision about what type of service to purchase online and where to make that purchase.

It was a fascinating experience to review the clients’ comments. While we do not have any plans now for future surveys, we will be conducting some as we go on. We do not present this in any way as an attempt at a “scientific study “so we will not respond (mostly for time’s sake) comments critical of the methodology we used.  Our goal here is simply to share information we found interesting. All comments and suggestions are welcome.

‘TIS THE HOLIDAY SEASON
I spent three Christmases in hospital; two I couldn’t even leave to go home for Christmas dinner.  Difficult to accept for all concerned, but I was just too unwell and they felt I was a risk.

So, three or four others and me sat in a gloomy dining room and picked at our ‘turkey dinner’.  Each dinner consisting of turkey roll, faux mashed potatoes, lukewarm gravy, a few veggies, stale roll and a packet of cranberry sauce and butter.   I did awaken to a gift planted on my side table; a decorative bag with some goodies, which I thought very sweet.

The Christmas year when permitted home, was only a two hour visit, and barely enough time to wolf down a holiday dinner.  As memory serves me, I believe we found a diner open and ate there; but don’t recall it being turkey.

Christmas mood in hospital was somber, the tree in the TV room stood virtually naked due to no string of lights permitted; could warrant a potential suicide attempt, only a few crocheted decorations placed sparingly.  Most patients were struggling greatly with this season; pressure put upon them with family holiday plans.  They tried their best to put on the façade of ‘smiles and cheer’, all the while they were drowning inside.  Who wants to even think of Christmas period?  For me, frankly, as far as receiving gifts I could have cared less.  That may sound ungrateful, however, when you are in such a state of blackness and hopelessness all that your mind can grasp is sometimes ‘nothing’.

I did have my family, but I was up to my neck in quicksand with this jail sentence called depression, and at my wits end at what to do.  The doctors; the profession that was supposed to rescue me from this ‘mess and pain’, didn’t do their jobs very well.  Here I was spending Christmas Day eating turkey roll off a styrofoam plate, while they would have ‘roasted chestnuts on the open-fire’ the night before, and carved a real turkey on Christmas Day.  Seems a trifle unfair, doesn’t it?

So, for this holiday season, just for a moment give a thought to someone who may be spending Christmas in the hospital.  That person deserves to be home looking at a brightly lit tree with some gifts underneath.  He/she maybe getting Christmas dinner in the hospital, but I can almost guarantee it will be turkey roll.

Happy Holidays.
Deb

Written by: ME

ScienceDaily (Dec. 22, 2009) — University of Rochester Medical Center researchers have pinpointed the prime factors identifying which elderly persons are at the highest risk for developing major depression.

The researchers, led by Jeffrey M. Lyness, M.D., professor of Psychiatry at the Medical Center, reported their findings in an article in the December issue of The American Journal of Psychiatry.

Preventive treatments for people in the high-risk group hold promise for providing the greatest health benefit at the lowest cost, the researchers concluded.

“People with low-level depressive symptoms, who perceive that they have poor quality social support from other people, and with a past history of depression, were at particularly high risk to develop new major depression within the one-to-four year time period of the study,” Lyness said. “This is good news, as we in the field are just learning how to prevent depression in particular high-risk groups. Future work will be able to test whether any of a variety of treatments — perhaps psychotherapy, perhaps medication, perhaps other things such as exercise — will help to prevent depression in persons suffering from the risks we identified in this study.”

More than 600 people who were 65 years of age or older took part in the study. They were recruited from private practices and University-affiliated clinics in internal medicine, geriatrics and family medicine in Monroe County, N.Y. Only participants without an active diagnosis of major depression were included in the analyses.

Annual follow-up in-person interviews were conducted for up to four years. Information obtained from telephone contacts and annual medical chart reviews supplemented the interviews. Thirty-three participants, or about 5.3 percent, developed an episode of major depression during the study period.

In their analysis, the researchers concluded the “number needed to treat,” an epidemiological measure used in determining the effectiveness of a medical intervention, was five. This means the fully effective preventive treatment of five individuals presenting the indicators would prevent one new case of major depression.

In an editorial in the journal, Warren D. Taylor, M.D., associate professor of Psychiatry at Duke University Medical Center, agreed the number needed to treat was low and indicated cost effectiveness.

“Given the compli­cations of depression in an elderly population, a preventive approach for this at-risk population may be quite important to not only prevent psychological suffering but to also avoid the deleterious effects of depression on comorbid medical illness,” Taylor wrote.

The researchers concluded “the present study may inform current clinical practice by fostering early detection and interven­tion critical to improving patient outcomes for depression.”

In addition to Lyness, authors of the article include: Wan Tang, Ph.D., research assistant professor of Biostatistics, Xin Tu, Ph.D., professor of Biostatistics and of Psychiatry, Yeates Conwell, M.D., professor of Psychiatry, and Qin Yu, Ph.D., research associate at the University of Pennsylvania.

Adapted from materials provided by University of Rochester Medical Center.

http://www.sciencedaily.com/releases/2009/12/091217115828.htm

Thought it was about time I gave you a bit of an update.

I dread christmas, due to various reasons; one of them being the loss of a close friend a couple of years ago. This year was no different, I’ve sort of enjoyed the build up, but as today got closer I hated it more.

Well, today is christmas (state the obvious there Steve), and I don’t know if it’s because I went out drinking last night that I’ve been feeling horrible all day. I’ve not wanted to speak to anyone; turned my phone off for a few hours, haven’t replied to many ‘Merry Christmas’ text messages and just in general not being myself. I’ve been quiet, irritable and wishing the world would disappear. I was really tired, so thought I would go for a sleep, but instead I lay thinking, imagining scenarios about what my friends are up to and it scared me.

My imagination does scare me at times, it runs away into a fantasy land, but not the magical kind. The fantasy land my head goes into is the one where everything and everyone is against me almost; in that world I am hated, talked about, people don’t understand me and I don’t like the person this fantasy land makes me feel like I am.

When I get out of the fantasy land, I have a little think and some of the things I feel I do believe, but some of them I refuse to believe.

I’ve lost my train of thought with where this blog was going, so I’m going to watch TV and hopefully something will cheer me up.

Merry Christmas everyone.

-x-x-x-

I can understand her comment. It wasn’t “you’re bipolar” or “I think you could be” or anything. She was letting me know the different options we had for medication if the current ones weren’t panning out as planned and that certain meds work better with people who are more in the bipolar range rather than simply just depression. That was basically her comment. It’s the first time she’s said as much, hence my strong reaction. I can understand, now that time has passed, why she said it. I just wasn’t prepared for it. I also knew that Lithium may come up because one time when I got my meds filled, the pharmacist asked me if I’d been on lithium when he was explaining one of my meds.

I just hate to be labelled, first of all, and second, while I know that bipolar people can lead normal lives and everything, I’ve known people who’ve been in and out of hospitals for years because of it. That is such a great fear of mine…I cannot even explain to you how scared I am of that.

I genuinely feel better. I really think the depression cloud has finally lifted (and I hope for some time or permanently!) and am happy about that. Although anxiety has rushed into fill it’s place, it’s a good change.

I still am pondering the whole “bipolar” issue. How do you know if you have a mental illness or if you’re just struggling as a result of situations/events? Does that make you have a mental illness?

I wish I could tell you that I was going great and that you could be too, but I can’t.  We have been traveling, I have been stressing and I haven’t been exercising, like, at all.  I store my pills on top of the refrigerator at my parent’s house (which is where my little family is for the holiday) and something happened that caused them to fall on the ground and spill everywhere.  I found (we found) most everything but the cogentin, which is designed to get rid of side effects.  If I miss it I’ll just be a walking zombie.  That’s all.

Got in to it a bit with a friend, one of my favorite people in the world, in fact.  She said in her blog that she knew that God wouldn’t give her more than she could handle.  I think that’s untrue.  If any of you, and I know all of you, have struggled with everything we struggle with, in your soul you know you’ve been given more.  She quoted 1 Corinthians 10:13. ” No temptation has seized you except what is common to man. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can stand up under it.” Wanna midrash it? Love ya! xoxo.  I love that verse, but that’s not what it means.

I wrote back:  I would love to. That verse is clearly talking about temptation. While he is working through you and around you and all about you, temptation may come your way and you will be able to resist it. That is the promise. If you are tempted there is a way out of that temptation, not that you are able to handle even the temptations thrown upon you – you will be able to get out of them – Not that you will not get more than you can handle. xxoo right back at you!

Does any of this help you?  It’s helped me in the past, I hope it helps you.  Some how revelations lose some of their sting after a while.  I just try and remember that when I hear this “God won’t give you any more than you can handle.”  Yes, he can.  Yes, he has.

I’ve been vomiting intermittently and my breasts have been very tender.  It’s times like that it’s hard not to imagine a little girl, maybe named Anna Lynn or a boy named Aaron.  There is no baby though, Mr. M’s vasectomy was five months ago and his doctor has never had a lapse.  It’s good, of course, we don’t need another child, six years younger than our first.  Exposed to all sorts of meds and born to a mother who is a whack job.  Small knows about my miscarriage, sweet little Isabella, and how she would have had a big sister.  I told her I wasn’t sad anymore.  And she said, “because of me?”  And I said, yes, because of you.

I almost didn’t write that.  I know not having a baby at the holidays can be even worse than usual.  The babies are dressed in precious little outfits.  People send family pics specifically to offend you or make you jealous.  Friends your younger sibling’s ages are bulging with unexpected pregnancies.  Does it ever end?   One year, shortly after I received the news that we were to have no more children, I was holding one of my brother’s friend’s newborns.  I wanted to throw it.  I didn’t realize how much it would hurt, or why these feelings would plague me.  It was only later, days later, even after a call to the psychiatrist who wanted me to go straight to the emergency room, that I guessed why it hurt so much and how I could hate this baby so much.

I have a friend who spends holidays at the coast.  She had an alcoholic father and has never had children.  She didn’t marry until late in life and her husband was agoraphobic.  He literally never went anywhere.  Any way, she was too sad coming to family events and feeling completely alone that she skips the whole thing.  I’m not recommending that, but it might be a way to cope for a year or two.  You’ve got to do what you’ve got to do.

I met up with my social worker this afternoon and we went for a walk in the snow. I know that I said I just wanted to be on my own at the moment and not see any professionals, but I really needed out of the house and well, I feel a bit better for it. It was absolutely freezing outside but the dogs were happy playing with their sticks and I had a good long chat about things and lots of fresh air. It felt good to get some things off my chest actually and I think just getting some air might even help me sleep tonight. I feel frazzled, emotionally and physically. I would love nothing more than to curl up with a cup of hot chocolate, watch a little television then fall asleep. But my mind has other ideas and is quite happy to be extremely awake as usual.

I am pretty worried about a friend of mine just now. She is in hospital after taking another overdose. It baffles me how somebody can quite obviously be in need of help and yet be offered none whatsoever from their CMHT. I was talking about the differences in mental health professionals today and when my friend gets out of hospital I am going to suggest to her that she asks her GP for a referral to be assessed by a Psychologist rather than a Psychiatrist. It makes interesting reading actually just to see the definitions of each, and how their assessment criteria’s are actually quite different.

PSYCHOLOGIST: A person trained and educated to perform psychological research, testing, and therapy.

PSYCHOLOGY: The science that deals with mental processes and behaviour. The emotional and behavioral characteristics of an individual, group, or activity.

PSYCHIATRIST: A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders.

PSYCHIATRY: Psychiatry is the diagnosis, treatment and prevention of mental health conditions.

So what this says to me is that there is quite clear differences between the two people and their roles. Firstly, one is a science and one is a branch of medicine. Although lots of mental health professionals work together to provide support, they all have different angles. In my opinion/understanding (I could be wrong here) -

A psychiatrist is there to make an assessment based on medical evidence first and foremost. He is looking to diagnose from a medical point of view and see what symptoms you have which match a criteria for a condition. Then he is going to treat it from a medical point of view, i.e. medication and he is going to meet up with you to talk about medication and how you are managing your condition.

A psychologist on the other hand is interested in the emotional and behavioural side of people. They help you get to the root cause of problems through talking therapies like CBT and help you find ways to cope emotionally. They are interested in the science of finding out why we are how we are and studying methods of talking therapies to see what is beneficial and what isn’t.

So, to go back to what I was saying a moment ago, about people who have difficulties in getting a diagnosis or finding out what it is that is wrong with them. I think it is important to look at both perspectives, the psychiatric one and the psychological one. I guess it is quite possible that a psychiatrist could see a patient and dismiss them as not fitting any criteria to make a diagnosis; whereas a psychologist isn’t quite so interested in a diagnosis or label, but instead in the persons behaviours. I feel sad for my friend that she is going through such a rough time at the moment and is lacking in consistent and beneficial support, but maybe now I think about it, being sent to a psychiatrist is the wrong thing for her. Maybe she actually needs to have a psychological assessment instead.

Hmm, I actually feel really bad writing about her when I can’t even check she doesn’t mind. But it’s not just about her, it’s about all of the people who know that there is something wrong with their moods or behaviours and cannot seem to get the right sort of help. The standard course of action for most GP’s seems to be: patient comes to see them with mental health problems – refer to psychiatrist for assessment. Now for me, the psychiatrist confirmed I had a condition there and then when I had an assessment done, but when I was having problems a few years beforehand, everything was just being brushed off as depression even though I was swinging back and forth with my moods just as badly then. But nobody knows you better than you know yourself and if you know that you are not feeling right, something has changed quite dramatically with your thoughts, feelings and behaviours and just isn’t going away then you are perfectly within your rights to ask for a psychological referral if a psychiatric one has not been useful.

Some disorders can take a long time to diagnose and I believe that Bipolar disorder is one of them. I have had the symptoms of Bipolar, the extreme moods for about seven years now but it was only a year ago I got the diagnosis. Sometimes it takes a few years to build up an accurate picture of your mental health before you can receive the best help. I have been diagnosed in the past with Depression, Anxiety, Post Traumatic Stress Disorder, Panic Attacks… all sorts of things. All along, it was bipolar, I guess it just took me having a full blown manic episode rather than the hypomanic ones to confirm the diagnosis.

But what is a diagnosis at the end of the day really? Is it anything more than a label? It really just shows that you have ticked enough boxes on a criteria checklist to say what sort of treatment would be the most appropriate and beneficial. I keep this blog and call it My Crazy Bipolar Life and refer to myself as Bipolar Girl on here. But that is not all I am or even who I am. It’s just the boxes I ticked to give me a label. That label gets me treatment to make me feel more normal. But what is normal? It is different for everyone. So if you know that you are not in your own “normal” state of mind, then don’t give up. Try the various angles available to you until you get the treatment that you deserve. You shouldn’t have to fight for it, but sometimes you end up having no choice. There are medications and other therapies out there that can make a big difference (so I’m told!!) so yes, don’t give up. Remember: the term mental health condition covers A LOT of mental health conditions, and a lot of them are very different from one another. Just like the term mental health professional, they are all different and it’s just a matter of finding the right therapeutic relationship that works and helps you to understand yourself… and ultimately to heal and learn to cope with life again.

Now that little rant is over, I am going to go and make some dinner. I am hoping to go and get my hair cut tomorrow – Xmas Eve I’ll be lucky! But it would be nice to feel as though I at least look a little more presentable for Xmas.

Bye for now bloggers.

My head blowing up.  Strangulation.  Echos of words from past lovers and friends that hurt, or disgust.  Flashbacks and regret.  Focusing on this I can never change.  Gun shots.  They come here like a game of 56 card pick up.  There is no stopping them however much I try to dwell on the book of Phillipians.  Life last night led to all this and more.  Have you been there?  No?  Well, welcome to the land of intrusive thoughts.

For whatever reason, I’m having bipolar flare ups this month.  Maybe it’s the evil one, and maybe it’s just that my doctor is in Pakistan and my psychologist (also doctor) is on vacation.  I have no professional support.  I have a supportive husband who tells me to exercise.  I have a little girl that keeps asking me to read things to her.  (Right now, and it’s bugging me, doesn’t she know I’m doing “The Lord’s Work”?).  I say that tongue in cheek.  I have a condescending mom and a guilt-ridden father.  I can write bad things about them all day long when I’m in this sort of state.

I threw up this morning, and did on Friday, too.  Once in between.  My first thought was either a reaction to too many vitamins, or a flu, but I’m only sick in the mornings.   Second thoughts were, “Might I be pregnant?”  My husband had a vasectomy five months ago, but we never went back and got it checked.  Until a couple of days we were scrupulous about birth control.  Although this baby would be welcome, it would be a difficult thing to do.  I would have to go off my meds completely, which would make, probably several trips) to the hospital necessary.  I don’t know how it works here but a doctor in my old town recommended electro-convulsive therapy.  That makes memory loss permanent, some times.  I’m just not sure about any of this.  I don’t feel like I need to be right now, let’s keep my head in the sand.

Now, back to those thoughts.  Stress is flaring up. People are at their worst and expectations only make things sadder and angrier.  I am trying so hard to be normal.  I don’t want to react to the baiting and pity I get.  I don’t need the first and don’t deserve the second.

I’m still making the presents which are “due” in two days.  I did finish what I had needed for today for our little family’s celebration.  I got annoyed at my husband but not too bad.  He is a person that does things his own way.  My expectations have made me very unhappy.  I readjusted them.  Things are better now.

You may recall the blog I wrote about the hospital getting rid of the Mental Health crisis line (The Psychiatric Triage) at the Latrobe Regional Hospital. I was very distressed about them getting rid of it, as I was one of the many depressed, psychotic and suicidal mental health patients that depends on that phone lines services.

It turns out the media made up a whole lot of bullshit about it.

At my last psychiatric appointment, the case manager asked what I’d been distressed about and why I couldn’t sleep. It was then that my boyfriend asked them if they would be eradicating the psychiatric Triage.
The psychiatric nurse said that the newspaper had twisted the truth – they weren’t getting rid of it, but just combining the day service and night service so that they could operate from the same building.

It made me think, why would the media twist a story like that?
Obviously they wanted attention and for sales of their newspaper to rise, but I’m sure they could have stated the facts instead of distressing all of the mental health patients in this region.

The media need to think about what they’re doing before they decide to publicise lies.

Parenting a Child with Bipolar Disorder
Parenting children who suffer from bipolar disorder or any emotional disorder is difficult. This article provides suggestions on what to do after hearing the startling diagnosis.
Read More

ScienceDaily (Dec. 22, 2009) — University of Rochester Medical Center researchers have pinpointed the prime factors identifying which elderly persons are at the highest risk for developing major depression.

The researchers, led by Jeffrey M. Lyness, M.D., professor of Psychiatry at the Medical Center, reported their findings in an article in the December issue of The American Journal of Psychiatry.

Preventive treatments for people in the high-risk group hold promise for providing the greatest health benefit at the lowest cost, the researchers concluded.

“People with low-level depressive symptoms, who perceive that they have poor quality social support from other people, and with a past history of depression, were at particularly high risk to develop new major depression within the one-to-four year time period of the study,” Lyness said. “This is good news, as we in the field are just learning how to prevent depression in particular high-risk groups. Future work will be able to test whether any of a variety of treatments — perhaps psychotherapy, perhaps medication, perhaps other things such as exercise — will help to prevent depression in persons suffering from the risks we identified in this study.”

More than 600 people who were 65 years of age or older took part in the study. They were recruited from private practices and University-affiliated clinics in internal medicine, geriatrics and family medicine in Monroe County, N.Y. Only participants without an active diagnosis of major depression were included in the analyses.

Annual follow-up in-person interviews were conducted for up to four years. Information obtained from telephone contacts and annual medical chart reviews supplemented the interviews. Thirty-three participants, or about 5.3 percent, developed an episode of major depression during the study period.

In their analysis, the researchers concluded the “number needed to treat,” an epidemiological measure used in determining the effectiveness of a medical intervention, was five. This means the fully effective preventive treatment of five individuals presenting the indicators would prevent one new case of major depression.

In an editorial in the journal, Warren D. Taylor, M.D., associate professor of Psychiatry at Duke University Medical Center, agreed the number needed to treat was low and indicated cost effectiveness.

“Given the compli­cations of depression in an elderly population, a preventive approach for this at-risk population may be quite important to not only prevent psychological suffering but to also avoid the deleterious effects of depression on comorbid medical illness,” Taylor wrote.

The researchers concluded “the present study may inform current clinical practice by fostering early detection and interven­tion critical to improving patient outcomes for depression.”

In addition to Lyness, authors of the article include: Wan Tang, Ph.D., research assistant professor of Biostatistics, Xin Tu, Ph.D., professor of Biostatistics and of Psychiatry, Yeates Conwell, M.D., professor of Psychiatry, and Qin Yu, Ph.D., research associate at the University of Pennsylvania.

Adapted from materials provided by University of Rochester Medical Center.

http://www.sciencedaily.com/releases/2009/12/091217115828.htm

My psychiatrist said this word today. She used it almost in passing. WTF.

She said that the Effexor could be causing cycling between depression and anxiety.

The definitions of mania are not what I experience with anxiety. I don’t even think hypomania is me.

She said Lithium could be a route medication wise.

Lithium. Bipolar. I am a complete freak. I refuse to accept it. That isn’t me.

On December 14, 2009, the Medical Board of California filed an Accusation against psychiatrist David Neal Glaser, alleging gross negligence, repeated negligent acts, prescribing without appropriate examination and medical indication; failure to maintain adequate and accurate medical records; self use of dangerous drugs and incompetence.

Glaser treated a female patient whom he met at a social gathering in December 2003 and with whom he carried on a romantic-sexual relationship from December 2003 to September 2004.

Specifically, the state’s document states that Glaser did not treat the patient/girlfriend in his office and did not keep usual and customary records on her, save for one dated July 3, 2004, which was itself not data obtained on that date but was “a compilation of information obtained over a period of ‘several months’.”

On March 27, 2004, Glaser called in a prescription for the patient for “Plan B,” a preparation used to prevent/terminate an unwanted pregnancy. Glaser did not have any records to support the use of this agent for the patient; no evidence of having performed a history or physical examination or even the use of a pregnancy test to substantiate the need for Plan B. Additionally, there was no evidence of discussion with the patient about the risk-to-benefit ratio of the drug or any discussion of follow-up care to be provided by respondent or a gynecologist.

Further, Glaser’s one note (July 3, 2004) contains diagnoses of obsessive-compulsive, major depressive disorder a “longstanding sleep disorder,” in absence of documentation, substantiation, testing, etc. The state’s document contains several other examples of Glaser’s treatment of the patient in absence of documentation, substantiation, etc.

Source: Accusation In the Matter of David Neal Glaser, M.D., Physician’s and Surgeon’s Certificate Number G 40041, Case No. 17-2007-184665, Medical Board of California Department of Consumer Affairs, filed December 14, 2009.

On August 13, 2009, the New Jersey State Board of Medical Examiners issued a Consent Order, reprimanding psychiatrist Mary Ann Ager for conduct consisting of repeated acts of negligence, malpractice or incompetence; engaging in professional or occupational misconduct; prescribing an excessive amount of a controlled substance and for remaining insufficiently alert to a patient’s dependence on prescribed substances.

The Order states specifically that the reprimand was the results of allegations that Ager “inappropriately prescribed pain medication for one patient” and with “prescriptions allowing her to obtain pain medication in dosage amounts exceeding appropriate levels prior to the patient’s death on January 19, 2007.”

Source: Consent Order in the Matter of the Suspension or Revocation of the License of Mary Ann Ager, M.D., license no. 25MA04458500, New Jersey State Board of Medical Examiners Administrative Action filed August 13, 2009.

Cross Promotion Planning

Cross-promotions allow us to combine an effective message with free distribution. In a sense, it is a new advertising medium with no monthly bills. There’s no newspaper space to buy or postage to pay.

That’s right — free.

Free advertising is a new concept to most therapists and other business owners, but the power of the cross-promotion was certainly understood some 200 years ago when used by Benjamin Franklin. In some early editions of “Poor Richard’s Almanac,” readers could take advantage of valuable coupons from various merchants of the day. Ben evidently felt that discount coupons added to the value of his publication, making it easier for him to sell.

Cross-promotions are sometimes called “poor man’s direct mail,” a term not so richly deserved, for they have made many a merchant anything but poor. Cross-promotions are truly one of the mass media alternatives that can deliver us through the ’90s.

Take, for example, Nautilus Fitness Center, which implemented one of the healthiest cross-promotions that I have seen. Nautilus’ manager met with the owner of a local tennis club to explain how the two companies could work together in a cross-promotion. After explaining how Nautilus’ equipment could help tennis players prevent tennis elbow and increase the power of their serves, he provided the owner with special half-price coupons for introductory memberships for the members of his club. The coupons would then be distributed as a value-added service from the tennis club, giving its members a little extra something for their loyalty.

Best of all for the tennis club owner, the program cost him nothing! Nautilus paid for the paper and printing of the 1,000 coupons that were inserted into the tennis club’s monthly newsletter. Nautilus had a great return on their investment: eight coupons were redeemed for introductory memberships. Five of those eight were converted to one-year memberships and one to a six-month membership. Gross sales for the promotion totaled $1,803, and it only cost Nautilus $40!

This scenario may sound painfully simple. It isn’t. A close look at all of the subtleties involved will reveal that it is a very complex marketing tool — a tool with a very low tolerance for abuse. Implemented improperly, it can cause some major grief. On the other hand, when used properly, it can increase your profits enormously.

THE THREE “C”S OF CROSS-PROMOTIONS

Cost

In the Nautilus Fitness Center example, the manager was able to have 1,000 coupons distributed for free. The only cost he incurred was the printing, which was very inexpensive.

Why would other people be willing to pass out your advertising for free? They wouldn’t — unless there is something in it for them. Therefore, you must create a perceived value for your cross-promotion partner. The Nautilus manager supplied the owner of the tennis club with 1,000 coupons representing thousands of dollars of savings for his members. Obviously, the Nautilus manager wasn’t giving up thousands of dollars, yet the owner perceived it as such.

The success of getting your advertising distributed for free depends on your ability to present the value of the program to your partner — to stress the “you” benefits. “We’re providing you with these coupons to provide to your customers, at no cost to you.”

Control

When advertising in a local newspaper or tabloid, you have very little control over your advertising. You can’t control how many messages go out, where they go or who gets them.

For the most part, using mass media means that your message goes out to the masses, but your customer base may be a very targeted group within it. With the cross-promotion, you have numeric, geographic and demographic control.

•Numeric Control. If your local newspaper has a circulation of 30,000, and you place a coupon in it, you have to distribute 30,000 coupons. Many times that may be way too much exposure. When you’re dealing with a limited amount of merchandise or can handle only a limited number of customers, numeric control can keep you from upsetting customers because you ran out of the item or they had to wait too long.

With the cross-promotion, you can limit the number of coupons you distribute. If the weekly customer count of your promotion partner is 15,000, and you want to pass out only 5,000 coupons, you provide only 5,000 coupons. Distribution can be limited to two or three days or until all the coupons have been distributed.

•Geographic Control. Even though some publications have zones that allow you to section off part of your distribution, you still have your advertising reaching a large area. With mass media, you may be reaching many people who probably won’t become your customers. If you have a number of locations, the mass media become more important, but even then you will find it valuable to have more control as to where your message is exposed.

•Demographic Control. In the mass media, you may be able to target by age and sex to some degree, but you are still reaching the masses and paying for it. With a cross-promotion, you can work with those merchants or organizations that will attract the type of people that will likely become your customers. For example, a restaurant may wish to cross-promote with a movie theater because after a movie, many people look for a place to eat. Likewise, customers of an office supply store may be prime candidates for quick printing services.

To determine good candidates for cross-promotion for your company, ask yourself, “What other types of products and services would my customer need?” People buying new formal wear would probably need dry cleaning services. Young couples buying engagement rings are usually in need of information about photographers and florists. Some businesses are natural complements to others.

Credibility

Perhaps the most interesting and beneficial aspect of cross-promotions is credibility. It is also the most subtle of the three C’s. However, it can be responsible for saving you thousands of dollars that might have been forfeited due to over discounting or over couponing.

When you advertise a discount or coupon in the newspaper, there is no doubt in any reader’s mind that you are buying that space to discount your products or services. You are, in effect, telling the public that you are willing to give them a break in price. Your regular price becomes meaningless since you are willfully disregarding it. People will respond to these ads, but if you coupon constantly, you may train your customers to expect a coupon all the time.

This problem is further compounded by having your employees asking customers if they have a coupon. That customer has just been informed that somewhere out there people have coupons and are paying less for the same items than he or she is.

As you’ll recall from the Nautilus example, the coupons they passed out said “compliments of” the tennis club. When those 1,000 members of the tennis club received their coupon, they didn’t think the Nautilus club was providing them. “Compliments of” implied that the tennis club had secured the coupons for them. The responsibility of the discount was transferred to the tennis club.

In some cases, your cross-promotion partner will like the idea so much that they will want you to do the same for them in a two-way cross-promotion. You will then each have coupons for the other partner’s business to distribute in an effort to trade customers without spending a large amount of money on advertising. In this situation, all printing and paper costs should be evenly split between both companies.

Whether you are setting up a one-way or two-way cross-promotion, it’s important to include all the proper disclaimers and qualifying information on your coupons. For example, you may want to limit the coupons to one per customer. It’s also a good idea to mention that your discount cannot be combined with any other coupons or special offers. Also, don’t forget an expiration date.

In essence, cross-promotion is people working together to help each other get the most from their advertising budget. Its brains over bucks, mind over money. It’s creating an “everyone wins” situation. Cross-promotion is boundless, limited only by your imagination.

SETTING UP CROSS-PROMOTION

When approaching a potential partner for a cross-promotion project, your attitude is important. You shouldn’t think of it so much as selling, but as an offer to participate in a valuable promotion. By building up the perceived value, you will most likely to get cooperation from your partners in both accepting the project and in implementing it.

Approach the person in charge and introduce yourself. Make sure you’re talking to the decision maker, not an assistant; relying on someone else to explain your proposal rarely works.

Be prepared to show some sample coupons to illustrate the proposed cross-promotion. It’s important for your credibility that the sample is real, not a photocopy or rough sketch.

Explain that you’ll pay for paper and printing costs for the coupons. Position the cross-promotion as a nice surprise for their customers when they pay their bills.

Agree on a time span for distribution; usually about one week. Ask for an average customer count during that time span so you know how many coupons to print.

Ask for a copy of their logo, preferably black on white.

If you want to make the coupon compliments of the manager, it’s nice to have his or her signature. Get it in a couple of different sizes in black ink.
Issue the manager a free card or token gift certificate of some kind. This is not a bribe, nor should it be treated as one. It’s merely a thank you for their cooperation. It will also help ensure that your coupons are distributed properly.

The next step is called the “glue,” because it helps hold the entire promotion together. Determine how many employees your partner has, and provide each one with a small token of appreciation. It can be a 10 percent discount card or anything else of more value than the coupons that the customers will receive, but less than the value of the manager’s gift. This will let the employees know you realize that stuffing these coupons in the bags or handing them out to customers is a little extra work, so you are making it worth their time.

Take the information to be printed on your coupons. Give yourself enough time to get it all done properly. Don’t promise to have the coupons ready in less than a week — you don’t want to risk any mistakes.

About the Writer: Jeff Slutsky is a professional speaker, consultant to many Fortune 500 firms and author of Street Smart Marketing and Streetfighting, which is based on finding low-cost advertising for companies.  This article originally appeared in the Summer 1996 issue of Entrepreneurial Edge.

School is finally done for the holidays and I’m back at home to celebrate. It has been going really good so far. More positives than negatives!

In my last session with school T, she reiterated that I am not a burden and I am not doing anything wrong by coming to see her. She really over-emphasizes things and for me, that is a good thing. I have to hear things over and over before I believe it. My “homework” is now to record the circumstances around the times of increased anxiety. I figure that is easy enough to do.

I have a psychiatrist appointment this coming week. I hope I have good news to tell this time! I still feel all over the place emotionally at times. Maybe that is just part of what it is like to be normal? Ha…I bock at the idea of normal since I have no idea what that is anymore.  I don’t know if things are really better (because they genuinely do seem to be) or if I’m trying to make them better by thinking they are – confused yet? You’ll have to forgive this girl…as women seem to always over think everything.

All of my shopping is done and I’ve even wrapped it all and put it under the tree! So, for now, I’ll try not to over think my life and just try and enjoy the good ride I’m currently on.

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*** Product Information and Prices Stored: Dec 19, 2009 07:05:06

E. Huff
Natural News
Friday, Dec 18th, 2009

A federal lawsuit has been filed against pharmaceutical giant AstraZeneca for its role in paying Chicago psychiatrist Dr. Michael Reinstein nearly $500,000 over the course of a decade to conduct research and to promote its anti-psychotic drug, Seroquel. Reinstein is being accused of wrongfully preying on thousands of mentally-ill patients in order to rake in profits for AstraZeneca.

Reinstein has a long history of working with AstraZeneca, receiving regular payments for speeches he would make across the country promoting the drug. AstraZeneca was also paying a for-profit research company, Uptown Research Institute, who in turn was paying Reinstein consulting fees for his services.

Cited in the lawsuit was the fact that Reinstein would continually prescribe roughly double the amount of drugs other psychiatrists would prescribe for the same conditions. When patients would report their pain and suffering due to the tremendous side effects of such drugs and their abnormally high dosages, Reinstein would largely ignore their concerns.

Other accusations include illegitimately prescribing Seroquel for various other conditions, including losing weight, despite the fact that studies show the drug actually causes weight gain. Reinstein was found to have made numerous false claims about Seroquel in promotional material, claims that would result in the destruction of people’s lives and health.

• A d v e r t i s e m e n t
• 

When all was said and done, more than 1,000 patients a year received Seroquel prescriptions from Reinstein at a cost of $7.6 million to taxpayers. It is unknown how many billions of dollars AstraZeneca has made from the widespread efforts of Reinstein in promoting the drug nationwide for all those years.

Despite all of his wrongdoings, Reinstein is not even a defendant in the case. AstraZeneca, the perpetrator which funded Reinstein, is the defendant in the lawsuit. While both Reinstein and AstraZeneca appear guilty of unethical and illegal behavior, AstraZeneca is rightfully bearing the brunt as it knowingly continued to fund Reinstein and rake in the profits of his misconduct.

The case brings up an important issue that plagues the pharmaceutical industry. The pharmaceutical money trail is never transparent, leading to questionable study results and improper marketing tactics. There is no accountability in the drug sector and this entire segment of the economy seems to be driven by deception and greed. Until people begin to demand restitution, the corruption will continue.

“When the people find they can vote themselves money, that will herald the end of the republic.” – Fall Of The Republic – Buy the DVD here

URL to article: http://www.infowars.com/big-pharma-paid-500000-to-chicago-psychiatrists-who-used-children-as-guinea-pigs/