When I started this Manic Depressive project, I said I wanted to write a post about what it's like for the family and friends of someone suffering from this disorder. It can be summed up in two words, “Challenging” and “Confusing”.
When the person you care about is cycling through their mood states and confused, how can YOU be anything other than confused? The challenge will still be there, but I'll try to clear up some of the confusion.
1st and foremost, YOU cannot “manage” your loved one's Manic Depression. Managing someone else's M/D is like trying to sight in a rifle while crossing the railroad tracks in a car with bad shock absorbers.
2nd Look into finding a support group for yourself. Other people ARE going through the same confusion and challenges you are experiencing.
Next, talk to your loved one. Sit down and ASK what you can do to help. Let them know you care about them, even though you may not understand exactly what they are experiencing. Tell them they have your support.
It may be helpful, for them and YOU to keep a log of behaviors and feelings they express at different times during a cycle of mania or depression. This can help in both their treatment and in recognizing the onset of a change in cycles. If the treatment provider is informed, s/he can makes changes to medications IF the symptoms are recognized early enough.
I also refer you back to the earlier post [from Sunday, October 5] where I listed things to know, things to say and things NOT to say to your loved one with M/D.
Keep in mind that your loved one's mood swings are NOT a character flaw or a deliberate effort to alienate you. This is an inherited disorder. They did not do something “wrong” and become M/D, they were born with the genetic coding for this disorder. It IS possible to cope with this disorder and regain functionality. It's hard work and requires an effort from all parties involved.
If you have any questions or comments you don't want to ask in the “Comments” section, you can email me at holly76209 at gmail dot com.
Thursday, October 16, 2008
Friday, October 10, 2008
Manic Depression Treatment Modalities
Recovery, as defined by SAMSHA (the Substance Abuse and Mental Health Services Administration/Center for Mental Health Services) (http://www.samhsa.gov/) is:
Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.
There are a broad range of treatments for Manic Depression. The best page I've seen is this one at the Depression and Bi Polar Support Alliance: http://dabsa.convio.net/site/PageServer?pagename=about_depression_treatmentmain . There are a TON, almost literally, of links on that page to cover every aspect of treatment.
The NIMH treatment page can be found here: http://www.nimh.nih.gov/health/publications/bipolar-disorder/treatment.shtml
I'd like to touch briefly on the treatments with which I have the most familiarity. Let me preface my remarks about medication by stating Psychotropic medicines should be prescribed by a Psychiatrist. While regular M.D.s CAN prescribe medicines to treat Manic Depression; Psychiatrists have more experience treating Manic Depression and are more knowledgeable about the latest medicines, drug interactions and and side effects.
Medications know as ”mood stabilizers” are on the front line in the battle against Manic Depression and its cycling feature. There are also anti-convulsant drugs that have mood stabilization as a side effect. For a list of medications please go to the NIMH's treatment page:
[http://www.nimh.nih.gov/health/publications/bipolar-disorder/treatment.shtml]
A caution about using anti-depressants to treat the Depression aspect of M/D. Studies, according to the NIMH have shown:
"that people with bipolar disorder are at risk of switching into mania or hypomania, or of developing rapid cycling, during treatment with antidepressant medication.15 Therefore, “mood-stabilizing” medications generally are required, alone or in combination with antidepressants, to protect people with bipolar disorder from this switch. "
The anecdotal evidence supports the assertion that people on antidepressants are more likely to have a more severe Depression when the manic period ends. I like to call This side effect “Rebound Depression.”
Psychotherapy/Talk therapy
Therapy can help prevent prevent inappropriate and negative behaviors. It can help the patient [and their family if involved in Family Therapy sessions] recognize the signs of the early stages of each cycle. Once this recognition is established, steps can be taken by the patient, family, therapist and psychiatrist working together to prevent a full blown episode of That aspect of the disorder.
The DBSA has a list of the benefits of therapy:
Understand your illness
Overcome fears or insecurities
Cope with stress
Make sense of past traumatic experiences
Separate your true personality from the mood swings caused by your illness
Identify triggers that may worsen your symptoms
Improve relationships with family and friends
Establish a stable, dependable routine
Develop a plan for coping with crises
Understand why things bother you and what you can do about them
End destructive habits such as drinking, using drugs, overspending or risky sex
Address symptoms like changes in eating or sleeping habits, anger, anxiety, irritability or unpleasant feelings
Therapy can also help you come to terms with the fact you will need medicine for the rest of your life. You CANNOT stop taking it because you feel better. That doesn't mean you're cured. If you go off of medication ALL your symptoms will return. You may be able to stop talk therapy once you've met your goals for therapy, but you will always need medication. The first medicine [or combination of medicines] you try, may not be the one for you. You may have to try several different medications before you find the one[s] that work for you. You may need to tweak the dosages over time, as well.
Despite the effort involved in finding the medicine[s], it's worth it when you fine the correct one[s] for you. The depressions are so much less intense and the mania is just enough to give you energy and creativity without causing the negative aspects of a full blown manic episode.
Another important aspect of treatment is a Thyroid Function test. According to NIMH, many Manic Depressives have abnormal thyroid functioning. Too much or too little of the hormone secreted by the thyroid can play hell with the patient's mood and cycling between moods. If necessary, get the medication and take it.
In some rare cases when medication and therapy are ineffective, ECT [electric convulsive therapy] may be utilized. The NIMH says:
In situations where medication, psychosocial treatment, and the combination of these interventions prove ineffective, or work too slowly to relieve severe symptoms such as psychosis or suicidality, electroconvulsive therapy (ECT) may be considered. ECT may also be considered to treat acute episodes when medical conditions, including pregnancy, make the use of medications too risky. ECT is a highly effective treatment for severe depressive, manic, and/or mixed episodes. The possibility of long-lasting memory problems, although a concern in the past, has been significantly reduced with modern ECT techniques. However, the potential benefits and risks of ECT, and of available alternative interventions, should be carefully reviewed and discussed with individuals considering this treatment and, where appropriate, with family or friends.
Even though Manic Depression is what's called a “long term illness” it can be treated. It IS possible to find recovery. The DBSA website :
http://dabsa.convio.net/site/PageServer?pagename=home
contains many links with suggestions that can help a newly diagnosed patient, a patient who has been diagnosed at sometime in the past, and family and friends cope in effective ways with this complex disorder.
If you are a Patient, take comfort in knowing there ARE many resources and solutions available to you. If you are a family member or friend looking to help, there are many strategies and methods you can utilize in supporting the patient. Both websites I've used for my references contain more links to help. Use them, and the sites they refer to as starting points on your personal journey to recovery. It IS possible.
Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.
There are a broad range of treatments for Manic Depression. The best page I've seen is this one at the Depression and Bi Polar Support Alliance: http://dabsa.convio.net/site/PageServer?pagename=about_depression_treatmentmain . There are a TON, almost literally, of links on that page to cover every aspect of treatment.
The NIMH treatment page can be found here: http://www.nimh.nih.gov/health/publications/bipolar-disorder/treatment.shtml
I'd like to touch briefly on the treatments with which I have the most familiarity. Let me preface my remarks about medication by stating Psychotropic medicines should be prescribed by a Psychiatrist. While regular M.D.s CAN prescribe medicines to treat Manic Depression; Psychiatrists have more experience treating Manic Depression and are more knowledgeable about the latest medicines, drug interactions and and side effects.
Medications know as ”mood stabilizers” are on the front line in the battle against Manic Depression and its cycling feature. There are also anti-convulsant drugs that have mood stabilization as a side effect. For a list of medications please go to the NIMH's treatment page:
[http://www.nimh.nih.gov/health/publications/bipolar-disorder/treatment.shtml]
A caution about using anti-depressants to treat the Depression aspect of M/D. Studies, according to the NIMH have shown:
"that people with bipolar disorder are at risk of switching into mania or hypomania, or of developing rapid cycling, during treatment with antidepressant medication.15 Therefore, “mood-stabilizing” medications generally are required, alone or in combination with antidepressants, to protect people with bipolar disorder from this switch. "
The anecdotal evidence supports the assertion that people on antidepressants are more likely to have a more severe Depression when the manic period ends. I like to call This side effect “Rebound Depression.”
Psychotherapy/Talk therapy
Therapy can help prevent prevent inappropriate and negative behaviors. It can help the patient [and their family if involved in Family Therapy sessions] recognize the signs of the early stages of each cycle. Once this recognition is established, steps can be taken by the patient, family, therapist and psychiatrist working together to prevent a full blown episode of That aspect of the disorder.
The DBSA has a list of the benefits of therapy:
Understand your illness
Overcome fears or insecurities
Cope with stress
Make sense of past traumatic experiences
Separate your true personality from the mood swings caused by your illness
Identify triggers that may worsen your symptoms
Improve relationships with family and friends
Establish a stable, dependable routine
Develop a plan for coping with crises
Understand why things bother you and what you can do about them
End destructive habits such as drinking, using drugs, overspending or risky sex
Address symptoms like changes in eating or sleeping habits, anger, anxiety, irritability or unpleasant feelings
Therapy can also help you come to terms with the fact you will need medicine for the rest of your life. You CANNOT stop taking it because you feel better. That doesn't mean you're cured. If you go off of medication ALL your symptoms will return. You may be able to stop talk therapy once you've met your goals for therapy, but you will always need medication. The first medicine [or combination of medicines] you try, may not be the one for you. You may have to try several different medications before you find the one[s] that work for you. You may need to tweak the dosages over time, as well.
Despite the effort involved in finding the medicine[s], it's worth it when you fine the correct one[s] for you. The depressions are so much less intense and the mania is just enough to give you energy and creativity without causing the negative aspects of a full blown manic episode.
Another important aspect of treatment is a Thyroid Function test. According to NIMH, many Manic Depressives have abnormal thyroid functioning. Too much or too little of the hormone secreted by the thyroid can play hell with the patient's mood and cycling between moods. If necessary, get the medication and take it.
In some rare cases when medication and therapy are ineffective, ECT [electric convulsive therapy] may be utilized. The NIMH says:
In situations where medication, psychosocial treatment, and the combination of these interventions prove ineffective, or work too slowly to relieve severe symptoms such as psychosis or suicidality, electroconvulsive therapy (ECT) may be considered. ECT may also be considered to treat acute episodes when medical conditions, including pregnancy, make the use of medications too risky. ECT is a highly effective treatment for severe depressive, manic, and/or mixed episodes. The possibility of long-lasting memory problems, although a concern in the past, has been significantly reduced with modern ECT techniques. However, the potential benefits and risks of ECT, and of available alternative interventions, should be carefully reviewed and discussed with individuals considering this treatment and, where appropriate, with family or friends.
Even though Manic Depression is what's called a “long term illness” it can be treated. It IS possible to find recovery. The DBSA website :
http://dabsa.convio.net/site/PageServer?pagename=home
contains many links with suggestions that can help a newly diagnosed patient, a patient who has been diagnosed at sometime in the past, and family and friends cope in effective ways with this complex disorder.
If you are a Patient, take comfort in knowing there ARE many resources and solutions available to you. If you are a family member or friend looking to help, there are many strategies and methods you can utilize in supporting the patient. Both websites I've used for my references contain more links to help. Use them, and the sites they refer to as starting points on your personal journey to recovery. It IS possible.
Wednesday, October 8, 2008
Treatment Blog in the Works
I'm workin' on the installment for this project about treatment options.
Just wanted y'all to know that.
Just wanted y'all to know that.
Sunday, October 5, 2008
Answering Comment Questions
Anonymous said...
How do you help someone with bipolar disorder? No insurance. Psychiatrists here are about as sane as Freud.
Well, Anonymous, there are a LOT of ways to help. The Depression and Bipolar Support Alliance [http://dabsa.convio.net/site/PageServer?pagename=about_helping]
has this list:
Helping Someone With A Mood Disorder
Mood disorders such as depression and bipolar disorder (also known as manic-depression) affect millions of people. Their family members and friends are affected too. If someone you love has a mood disorder, you may be feeling helpless, overwhelmed, confused and hopeless, or you may feel hurt, angry, frustrated and resentful. You may also have feelings of guilt, shame and isolation, or feelings of sadness, exhaustion and fear. All of these feelings are normal.
What you need to know:
Your loved one’s illness is not your fault (or your loved one’s fault).
You can’t make your loved one well, but you can offer support, understanding and hope.
Each person experiences a mood disorder differently, with different symptoms.
The best way to find out what your loved one needs from you is by asking direct questions.
What you need to find out:
Contact information (including emergency numbers) for your loved one's doctor, therapist, and psychiatrist, your local hospital, and trusted friends and family members who can help in a crisis.
Whether you have permission to discuss your loved one's treatment with his or her doctors, and if not, what you need to do to get permission.
The treatments and medications your loved one is receiving, any special dosage instructions and any needed changes in diet or activity.
The most likely warning signs of a worsening manic or depressive episode (words and behaviors) and what you can do to help.
What kind of day-to-day help you can offer, such as doing housework or grocery shopping.
When talking with your loved one's health care providers, be patient, polite and assertive. Ask for clarification of things you do not understand. Write down things you need to remember.
What you can say that helps:
You are not alone in this. I’m here for you.
I understand you have a real illness and that’s what causes these thoughts and feelings.
You may not believe it now, but the way you’re feeling will change.
I may not be able to understand exactly how you feel, but I care about you and want to help.
When you want to give up, tell yourself you will hold on for just one more day, hour, minute - whatever you can manage.
You are important to me. Your life is important to me.
Tell me what I can do now to help you.
I am here for you. We will get through this together.
What you should avoid saying:
It’s all in your head.
We all go through times like this.
You’ll be fine. Stop worrying.
Look on the bright side.
You have so much to live for; why do you want to die?
I can’t do anything about your situation.
Just snap out of it.
Stop acting crazy.
What’s wrong with you?
Shouldn’t you be better by now?
The National Institute for Mental health has a list of suggestions for finding services
and the DBSA has a list of suggestions called "Choosing a Provider" and Professional Referral has tips on what to remember when choosing a provider of Mental Health Services as well as links to resources.
http://dabsa.convio.net/site/PageServer?pagename=empower_resources
I hope these links help...and I'll comeback to discuss this in more detail later.
How do you help someone with bipolar disorder? No insurance. Psychiatrists here are about as sane as Freud.
Well, Anonymous, there are a LOT of ways to help. The Depression and Bipolar Support Alliance [http://dabsa.convio.net/site/PageServer?pagename=about_helping]
has this list:
Helping Someone With A Mood Disorder
Mood disorders such as depression and bipolar disorder (also known as manic-depression) affect millions of people. Their family members and friends are affected too. If someone you love has a mood disorder, you may be feeling helpless, overwhelmed, confused and hopeless, or you may feel hurt, angry, frustrated and resentful. You may also have feelings of guilt, shame and isolation, or feelings of sadness, exhaustion and fear. All of these feelings are normal.
What you need to know:
Your loved one’s illness is not your fault (or your loved one’s fault).
You can’t make your loved one well, but you can offer support, understanding and hope.
Each person experiences a mood disorder differently, with different symptoms.
The best way to find out what your loved one needs from you is by asking direct questions.
What you need to find out:
Contact information (including emergency numbers) for your loved one's doctor, therapist, and psychiatrist, your local hospital, and trusted friends and family members who can help in a crisis.
Whether you have permission to discuss your loved one's treatment with his or her doctors, and if not, what you need to do to get permission.
The treatments and medications your loved one is receiving, any special dosage instructions and any needed changes in diet or activity.
The most likely warning signs of a worsening manic or depressive episode (words and behaviors) and what you can do to help.
What kind of day-to-day help you can offer, such as doing housework or grocery shopping.
When talking with your loved one's health care providers, be patient, polite and assertive. Ask for clarification of things you do not understand. Write down things you need to remember.
What you can say that helps:
You are not alone in this. I’m here for you.
I understand you have a real illness and that’s what causes these thoughts and feelings.
You may not believe it now, but the way you’re feeling will change.
I may not be able to understand exactly how you feel, but I care about you and want to help.
When you want to give up, tell yourself you will hold on for just one more day, hour, minute - whatever you can manage.
You are important to me. Your life is important to me.
Tell me what I can do now to help you.
I am here for you. We will get through this together.
What you should avoid saying:
It’s all in your head.
We all go through times like this.
You’ll be fine. Stop worrying.
Look on the bright side.
You have so much to live for; why do you want to die?
I can’t do anything about your situation.
Just snap out of it.
Stop acting crazy.
What’s wrong with you?
Shouldn’t you be better by now?
The National Institute for Mental health has a list of suggestions for finding services
and the DBSA has a list of suggestions called "Choosing a Provider" and Professional Referral has tips on what to remember when choosing a provider of Mental Health Services as well as links to resources.
http://dabsa.convio.net/site/PageServer?pagename=empower_resources
I hope these links help...and I'll comeback to discuss this in more detail later.
Wednesday, October 1, 2008
Signs and Syptoms of Manic Depression
The below was shamelessly copied and pasted from http://www.nimh.nih.gov/health/publications/bipolar-disorder/symptoms.shtml
Keep in mind, while readin' this that some folks are MIS-diagnosed as depressed when their manic episodes are mild or what's called “hypomanic.”
I'm going to put my comments and observations in a different font and color from the NIMH text.
Bipolar disorder causes dramatic mood swings—from overly “high” and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.
Signs and symptoms of mania (or a manic episode) include:
Increased energy, activity, and restlessness Lots and lots of energy leads to lots of activity. But the restlessness can cause a person to start multiple projects when they're manic, then never complete them because the depressive cycle hits.
Excessively “high,” overly good, euphoric mood
Extreme irritability Snapping turtle sound familiar? How about rantin' and ravin'?
Racing thoughts and talking very fast, jumping from one idea to another
Distractibility, can’t concentrate well See the above comment under energy.
Little sleep needed
Unrealistic beliefs in one’s abilities and powers
Poor judgment
Spending sprees
A lasting period of behavior that is different from usual
Increased sexual drive When combined with poor judgement...bad things can happen
Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
Provocative, intrusive, or aggressive behavior As if they no longer have a censor feature in their brain.
Denial that anything is wrong Because no matter how bad it IS, there are also positive aspects to Mania. More about that later.
A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.
Signs and symptoms of depression (or a depressive episode) include:
Lasting sad, anxious, or empty mood lasting is the Key word in this clause.
Feelings of hopelessness or pessimism Hopelessness is also a suicidal precursor
Feelings of guilt, worthlessness, or helplessness helplessness is another suicidal precursor
Loss of interest or pleasure in activities once enjoyed, including sex A low libido is the counterpart of the hypersexuality sometimes seen in Manic episodes
Decreased energy, a feeling of fatigue or of being “slowed down” lethargy, to those unaware of symptoms, can be mis-interpreted as "laziness" instead of a legitimate symptom
Difficulty concentrating, remembering, making decisions
Restlessness or irritability which can also be a mania symptom
Sleeping too much, or can’t sleep the extremes and the difference between sleep patterns when in a Manic episode or on an even keel is the Key factor to this symptom
Change in appetite and/or unintended weight loss or gain As with the above, it's the extremes to look for
Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury which is why a lot of people with depression are MIS-diagnosed as having Fibromyalgia. Thoughts of death or suicide, or suicide attempts
A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.
Other sources, the Medical Library Association [in conjunction with NIMH, btw] also lists inflated self esteem, lack of self control and binges of eating or drinking as Manic Episode Symptoms. What NO source lists, and what many M-Ds are reluctant to sacrifice are the bursts of artistic creativity they experience during manias. To them, being medicated is the same as losing their Muse. Jamison writes about this aspect of treating Manic Depression in Touched with Fire: Manic Depressive Illness and the Artistic Temperament. She urges treatment that doesn't kill that fire in the process of "curing" the Disorder.
That last would be because there IS no "cure" for Manic Depression. There's treatment, but if you're an M-D, you're always going to BE and M-D. You may get the mood swings under control with medication, but you will need that medication for the rest of your life. Kinda like being hypertensive or a diabetic.
Okey, dokey. We clear on all that? I didn't think so.
Keep in mind, while readin' this that some folks are MIS-diagnosed as depressed when their manic episodes are mild or what's called “hypomanic.”
I'm going to put my comments and observations in a different font and color from the NIMH text.
Bipolar disorder causes dramatic mood swings—from overly “high” and/or irritable to sad and hopeless, and then back again, often with periods of normal mood in between. Severe changes in energy and behavior go along with these changes in mood. The periods of highs and lows are called episodes of mania and depression.
Signs and symptoms of mania (or a manic episode) include:
Increased energy, activity, and restlessness Lots and lots of energy leads to lots of activity. But the restlessness can cause a person to start multiple projects when they're manic, then never complete them because the depressive cycle hits.
Excessively “high,” overly good, euphoric mood
Extreme irritability Snapping turtle sound familiar? How about rantin' and ravin'?
Racing thoughts and talking very fast, jumping from one idea to another
Distractibility, can’t concentrate well See the above comment under energy.
Little sleep needed
Unrealistic beliefs in one’s abilities and powers
Poor judgment
Spending sprees
A lasting period of behavior that is different from usual
Increased sexual drive When combined with poor judgement...bad things can happen
Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
Provocative, intrusive, or aggressive behavior As if they no longer have a censor feature in their brain.
Denial that anything is wrong Because no matter how bad it IS, there are also positive aspects to Mania. More about that later.
A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.
Signs and symptoms of depression (or a depressive episode) include:
Lasting sad, anxious, or empty mood lasting is the Key word in this clause.
Feelings of hopelessness or pessimism Hopelessness is also a suicidal precursor
Feelings of guilt, worthlessness, or helplessness helplessness is another suicidal precursor
Loss of interest or pleasure in activities once enjoyed, including sex A low libido is the counterpart of the hypersexuality sometimes seen in Manic episodes
Decreased energy, a feeling of fatigue or of being “slowed down” lethargy, to those unaware of symptoms, can be mis-interpreted as "laziness" instead of a legitimate symptom
Difficulty concentrating, remembering, making decisions
Restlessness or irritability which can also be a mania symptom
Sleeping too much, or can’t sleep the extremes and the difference between sleep patterns when in a Manic episode or on an even keel is the Key factor to this symptom
Change in appetite and/or unintended weight loss or gain As with the above, it's the extremes to look for
Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury which is why a lot of people with depression are MIS-diagnosed as having Fibromyalgia. Thoughts of death or suicide, or suicide attempts
A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.
Other sources, the Medical Library Association [in conjunction with NIMH, btw] also lists inflated self esteem, lack of self control and binges of eating or drinking as Manic Episode Symptoms. What NO source lists, and what many M-Ds are reluctant to sacrifice are the bursts of artistic creativity they experience during manias. To them, being medicated is the same as losing their Muse. Jamison writes about this aspect of treating Manic Depression in Touched with Fire: Manic Depressive Illness and the Artistic Temperament. She urges treatment that doesn't kill that fire in the process of "curing" the Disorder.
That last would be because there IS no "cure" for Manic Depression. There's treatment, but if you're an M-D, you're always going to BE and M-D. You may get the mood swings under control with medication, but you will need that medication for the rest of your life. Kinda like being hypertensive or a diabetic.
Okey, dokey. We clear on all that? I didn't think so.
Tuesday, September 30, 2008
Manic Depression Project
One of my favorite authors on Mental Health topics is Kay Redfield Jamison. I first read her An Unquiet Mind about 3 or 4 years ago. It impressed me because she was brave enough to discuss her own struggle with Manic Depression. Because despite what people may say about “enlightened” and accepting attitudes, there is STILL an incredible amount of discrimination against some diagnoses.
The openness of many high-profile Depression-affected individuals helped to erase the ignorance and attendant stigma associated with that diagnosis. Manic Depressives have not enjoyed the same acceptance. The last time I heard about someone with Manic Depression [or Bi-Polar Disorder] it was because they had “gone off their meds” and committed some high profile crime, i.e. a mass shooting, kidnapping a child, murder/suicide in a domestic arrangement.
Redfield broke new ground by telling about her disorder and how it affected her pursuit of an advanced degree. Since she is on faculty at Johns Hopkins Medical School, she may have an advantage in gaining the acceptance of her co-workers. One would assume, once she had tenure, she could say a LOT of things an un-tenured professor could not. I think her expertise in the psychological field is ENHANCED by her disorder. She has a view of Manic Depression from Both sides of the desk. Training new psychologists and psychiatrists, she is in a unique position to expand their understanding of future patients.
I want to talk about Manic Depression here. What it's like for the patient; what it's like for those close to the patient. There are some unique challenges to this disorder. You may have a Manic Depressive in your life who has been a mystery to you. You may work with one, for one, love one, or have your life impacted by this disorder, and not even recognize what's going on.
I want to make this, ideally, a multi-part posting. I will talk about symptoms and signs in one post. The next will talk about various treatment modalities. Yet another will address what it's like to live with a Manic Depressive and how to cope/ help them cope with those pesky mood swings.
SO, y'all think about questions you might have. You can leave them in comments, if you like. As I progress through this opus, I'll try to cover any questions posed, as well as writing about the subjects I outlined above.
Stay tuned.
The openness of many high-profile Depression-affected individuals helped to erase the ignorance and attendant stigma associated with that diagnosis. Manic Depressives have not enjoyed the same acceptance. The last time I heard about someone with Manic Depression [or Bi-Polar Disorder] it was because they had “gone off their meds” and committed some high profile crime, i.e. a mass shooting, kidnapping a child, murder/suicide in a domestic arrangement.
Redfield broke new ground by telling about her disorder and how it affected her pursuit of an advanced degree. Since she is on faculty at Johns Hopkins Medical School, she may have an advantage in gaining the acceptance of her co-workers. One would assume, once she had tenure, she could say a LOT of things an un-tenured professor could not. I think her expertise in the psychological field is ENHANCED by her disorder. She has a view of Manic Depression from Both sides of the desk. Training new psychologists and psychiatrists, she is in a unique position to expand their understanding of future patients.
I want to talk about Manic Depression here. What it's like for the patient; what it's like for those close to the patient. There are some unique challenges to this disorder. You may have a Manic Depressive in your life who has been a mystery to you. You may work with one, for one, love one, or have your life impacted by this disorder, and not even recognize what's going on.
I want to make this, ideally, a multi-part posting. I will talk about symptoms and signs in one post. The next will talk about various treatment modalities. Yet another will address what it's like to live with a Manic Depressive and how to cope/ help them cope with those pesky mood swings.
SO, y'all think about questions you might have. You can leave them in comments, if you like. As I progress through this opus, I'll try to cover any questions posed, as well as writing about the subjects I outlined above.
Stay tuned.
Wednesday, January 30, 2008
A Question from North of the Border
I got a letter from a student in Canada. S/He [in the interest of anonymity] wanted some advice about working in Parole specializing with women or youth populations.
I have NO idea how the Parole system operates in Canada, to be perfectly frank.
Here in the USA, the Parole systems vary from State to State. Some states combine Parole with Probation and others, like Texas [where I am] keep them seperate.
The average citizen, one who has never been or had a family member, on Probation or Parole tends to confuse the two very different jobs.
As far as specializing in Women or Youth... the only way I can think of to do that [and I'm just takin' a WILD Assed Guess here] would be to take a position as what is called [here in Texas] as an Institutional Parole Officer. IPOs work IN the prisons interviewing prospective parolees about their plans for release and verifying those plans with the friends or family. Those same plans would apply to working in a youth facility where young women are incarcerated. I think, but don't know, that parole officers working with youthful offenders have more contact with their "clients" than IPOs do.
That's the drawback with being an IPO...there is no on-going contact with the parolee. If that's what you're loooking for. Of course a lot of Parole Officers with burn-out issues find the limited contact a nice change from the intense contact with the same parolees.
What you might want to consider, if you're just starting a career in Criminal Justice, with a degree in Sociology, is a year working for Juvenile Probation. offenders. That would give you a chance to see if you actually like working with youthful offenders. Some caseworkers think they will like working with troubled youth because they like working with youth populations in other situations. Youthful offenders are a different kettle of fish, however.
You could always call the Human Resources office and ask questions. If they are as desperate for workers as all the State Agencies down here are, they will be happy to answer your questions. You might even be able to set up a meeting with a Supervisor to discuss your interests and how they mesh with the requirements of the Canadian system.
Good Luck and let me know how thing work out.
If any of you readers have knowledge or experience with the Canadian Criminal Justice System, please share that info with this blogger and the Student writer.
I have NO idea how the Parole system operates in Canada, to be perfectly frank.
Here in the USA, the Parole systems vary from State to State. Some states combine Parole with Probation and others, like Texas [where I am] keep them seperate.
The average citizen, one who has never been or had a family member, on Probation or Parole tends to confuse the two very different jobs.
As far as specializing in Women or Youth... the only way I can think of to do that [and I'm just takin' a WILD Assed Guess here] would be to take a position as what is called [here in Texas] as an Institutional Parole Officer. IPOs work IN the prisons interviewing prospective parolees about their plans for release and verifying those plans with the friends or family. Those same plans would apply to working in a youth facility where young women are incarcerated. I think, but don't know, that parole officers working with youthful offenders have more contact with their "clients" than IPOs do.
That's the drawback with being an IPO...there is no on-going contact with the parolee. If that's what you're loooking for. Of course a lot of Parole Officers with burn-out issues find the limited contact a nice change from the intense contact with the same parolees.
What you might want to consider, if you're just starting a career in Criminal Justice, with a degree in Sociology, is a year working for Juvenile Probation. offenders. That would give you a chance to see if you actually like working with youthful offenders. Some caseworkers think they will like working with troubled youth because they like working with youth populations in other situations. Youthful offenders are a different kettle of fish, however.
You could always call the Human Resources office and ask questions. If they are as desperate for workers as all the State Agencies down here are, they will be happy to answer your questions. You might even be able to set up a meeting with a Supervisor to discuss your interests and how they mesh with the requirements of the Canadian system.
Good Luck and let me know how thing work out.
If any of you readers have knowledge or experience with the Canadian Criminal Justice System, please share that info with this blogger and the Student writer.
Saturday, January 19, 2008
Haiku about being a P.O.
For those of you who don't read my other blog...here's one of the Haiku I submitted Wednesday last in the Haiku contest Sparrow sponsors every week:
Parole Officer
sending felons back to prison
Wish they would stay there!!!
That wasn't the one that won..but it was my second favorite.
If any of y'all have a yen to send a Deluxe Care Package to any member of our Armed Services currently serving in harm's way...come on over to Sparrow's on Wednesday and enter the Haiku contest. That's what the winner gets...besides the honor of winning. They get to designate the recipient of a Deluxe Care Package.
Parole Officer
sending felons back to prison
Wish they would stay there!!!
That wasn't the one that won..but it was my second favorite.
If any of y'all have a yen to send a Deluxe Care Package to any member of our Armed Services currently serving in harm's way...come on over to Sparrow's on Wednesday and enter the Haiku contest. That's what the winner gets...besides the honor of winning. They get to designate the recipient of a Deluxe Care Package.
Friday, January 11, 2008
Advice to a Would-Be Parole Officer, Part Deaux
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A Belated Note of Thanks
To the Anonymous Parole Officer with whom I corresponded in September:
The blog I posted Wednesday [about the negative aspects of being a Parole Officer] would not have had as much authenticity without the input I received from you.
As I have stated many times, I've been out of the "game" a long time. But our letters back in September let me know that things haven't changed. The mere fact that you were thrilled to have a blog based on the letter you wrote to me back then and the things you said in answer to my questions let me know that The State in general and The Board and its minions in particular haven't changed in my absence.
Thank you for the information. But more importantly, THANK YOU and every other P.O. for doing the jobs you do. Thanks for keeping an eye on these men and women released from our prison system, some because their good behavior warranted it, and some because their good time + their time served = their total sentence so they get released whether they deserve it or not!
Thanks for being over-worked and underpaid. Thanks for paying for a Bachelor's degree and now taking home less than $2k/month after taxes, retirement and insurance are deducted. Bet you're wishing you'd Majored in Business or Computer Science now, huh?
Thanks for taking the crap, the nitpicking and petty BS you have to put up with from burned out Unit Supervisors, Regional Supervisors, and seen-it-all Hearing Officers who have forgotten what it was like to BE a P.O.
Thanks for the unpaid overtime you have to put in every week in order to get all the office visits, home visits, case file documentation, Reports of Violations and all the other myriad duties accomplished. And thanks for taking on the job of Lab Tech, too. Don't you just love how you have to go into the restroom and supervise the collection [or beg an officer of the same gender to do this for you w/you opposite gender parolees] of Urine Samples? And then, after Duty Day is done, you get to test all those stinky little cups. Is the State paying for your HepB vaccination, by the way?
Jaysus, Mary and all the Apostles!!! It's been 17 years and things are worse than ever!
So THANK YOU, THANK YOU ALL SO VERY, VERY MUCH!!!
The blog I posted Wednesday [about the negative aspects of being a Parole Officer] would not have had as much authenticity without the input I received from you.
As I have stated many times, I've been out of the "game" a long time. But our letters back in September let me know that things haven't changed. The mere fact that you were thrilled to have a blog based on the letter you wrote to me back then and the things you said in answer to my questions let me know that The State in general and The Board and its minions in particular haven't changed in my absence.
Thank you for the information. But more importantly, THANK YOU and every other P.O. for doing the jobs you do. Thanks for keeping an eye on these men and women released from our prison system, some because their good behavior warranted it, and some because their good time + their time served = their total sentence so they get released whether they deserve it or not!
Thanks for being over-worked and underpaid. Thanks for paying for a Bachelor's degree and now taking home less than $2k/month after taxes, retirement and insurance are deducted. Bet you're wishing you'd Majored in Business or Computer Science now, huh?
Thanks for taking the crap, the nitpicking and petty BS you have to put up with from burned out Unit Supervisors, Regional Supervisors, and seen-it-all Hearing Officers who have forgotten what it was like to BE a P.O.
Thanks for the unpaid overtime you have to put in every week in order to get all the office visits, home visits, case file documentation, Reports of Violations and all the other myriad duties accomplished. And thanks for taking on the job of Lab Tech, too. Don't you just love how you have to go into the restroom and supervise the collection [or beg an officer of the same gender to do this for you w/you opposite gender parolees] of Urine Samples? And then, after Duty Day is done, you get to test all those stinky little cups. Is the State paying for your HepB vaccination, by the way?
Jaysus, Mary and all the Apostles!!! It's been 17 years and things are worse than ever!
So THANK YOU, THANK YOU ALL SO VERY, VERY MUCH!!!
Tuesday, January 8, 2008
Advice to a Would-Be Parole Officer
I got a letter about 3 weeks ago from a fella who is considering a career change. He wants me to give him the straight story on what it's like to be a Parole Officer. Well, wanting to be fair, I have to tell you, I LEFT Parole and didn't let the door hit my ass on the way out in November '91. So my personal experience is not exactly up-to-date.
However, a few months ago I exchanged email with a current Sex Offender P.O. and I spent several hours reading web page propaganda on the TDCJ site. I also spent a few years working for TDHS [TX Dept. of Human Services]. That's your first lesson, class. When you go to work for Uncle Sam or Uncle Sam Houston, be prepared to start learning a different language, the language of abbreviations.
I used to drive my kids and Mother NUTS talking in abbreviations. They hated that. I still lapse back in to that letter-speak from time to time. My Daughter, the English major, gets all uppity and makes snide remarks about wasting my education and fine vocabulary. I just smile inwardly, and bide my time. When she becomes a teacher she'll have her very own secret language from TEA and PTA et al.
Next on my list of warnings... it all depends on the Unit Supervisor you draw. The person who supervises you on a day to day basis can determine whether you have a successful or a shitty career. As can your ability to keep your head down and out of office politics. Listen very carefully to my next: ALL State Agencies, by their very existence and dependence upon the Lege for funding and their bureaucratic structure always have been and always will be political. Unless you can stay out of the politics, or you are an EXPERT political animal or you can survive having your ass handed to you by someone who IS a Political Predator...reconsider going to work for a State Agency. Or, try it for a year, and if things are working out, then you can try it for another year...but please don't start planning a career until you've lasted at least 5 years. If you have not risen to P.O. III, or Hearing Officer after five years...consider switching to Probation or the Feds.
The beginning salary and what you can expect after 2 years and then 5 years can be found by navigating through the link I gave you above. I will say it's more than what I was making when I left, 17 yrs ago, but that's to be expected after all this time, what with COLAs and the fact that they were literally bleeding new P.O.s for awhile. They had to increase salaries in an effort to keep them.
They induce the Type A P.O.s to take on the specialized caseloads that I discussed back in September [I think, maybe it was October] by appealing to their egos. "Oh, not just any P.O. can handle a caseload like this." "It takes a SPECIAL officer to handle the challenges of a caseload made up of these kinds of releasees." Do NOT fall for this trap!! I can't even believe they are still gettin' away with using that crap!
In 1988 I was one of the first Sex Offender Parole Officer Texas had. I was one of their guinea pigs. We went to Austin for a week in the Spring. Then in December we went to Padre Island for a week and that was what they called training. Of course we started seeing sex offender parolees right after we got back in the Spring. There wasn't then and isn't now a distinction made between Rapists and Pedophiles. However there is a world of difference in the way to approach those offenders, both because of the way their minds work and for officer safety reasons. BAD JuJu, very bad JuJu!
But the 'crats at the top of the heap at TDCJ-PPD have been gettin' away with connin' the best officers into workin' these high stress caseloads because they choose the officers who love a frickin' challenge. Oh, yes we do. [do I sound bitter? I get that way when my soul is sucked dry and the husk thrown away. I'm touchy about that.]
The workloads? Oh, lets see they are about 1/2 again as much as normal humans can handle during a 40 hour work-week. Of course there IS no such thing as OT when you work for the State. We used to be able to accumulate "Comp" time which we had to use in the same week we earned it. In other words, if you worked late on Tuesday because you had to do home visits, then you had to take the same number of hours off before 5 p.m. Friday or you just gave the State your time. However, if you got stuck with Friday as a "Duty Day" and had to be in the office that day and a bunch of parolees got released on Thursday and reported on Friday and their P.O.s were out and you had to see them instead as well as your own parolees who were there for their monthly report and you wound up working until 6 or 7 pm, well the entire TDCJ appreciated the donation of your time. I don't imagine that has changed either, but YMMV.[your mileage may vary]
I hope by now that they have switched to computerized records, but I doubt it. It is after all a State Bureaucracy. When I left, they were just getting computers. By now I'm sure every P.O. has a desktop and some may even have laptops for field use. BUT, and I hope I'm wrong, but I'd bet you $5 that officers, at a minimum, have to print off a copy of everything they put in the E-file and maintain a paper file, too. That's the bureaucratic mindset. If it's not on paper, it's not real.
In any case, every contact with or in connection with a releasee MUST be documented. Every phone call, every office, home and job site visit must be written in the case file. If the parolee goes to counselling, the documentation he brings in to prove to you he has attended and paid for his counselling must be noted and a copy placed in the file. His documentation for AA/NA must also be written in your notes and a copy placed in the file.
When I was still with Parole they were experimenting with having P.O.s collect and test urine samples from parolees. We had three different test kits so we could test for opiates, cocaine and marijuana. [BTW, you would have to eat a ridiculous amount of poppy seed hamburger buns, the BIG ones before your urine would test + for opiates, same for being in the same room where other people were smokin' dope and that's why you tested + for MaryJane. What? Were they super chargin' you? Go peddle that story somewhere else, cause I ain't senile so I'm not buyin' it.] Now when you submit your application for employment to the Human Resources folks, they don't warn you about this kind of stuff. My degree is in Social Work, not biology or chemistry. I most definitely did NOT sign on to carry some felon's hot pee around in a plastic cup and then run 3 tests on it, AFTER work hours when I should have been home with my kids or going out to dinner with that long, tall, gorgeous, hunk of man who is now my Dearly Beloved. So, you up for that, Pilgrim?
If I had been able to get OUT of my District Parole Office and become a hearing officer or get a transfer to Institutional Parole Officer, I probably would have stayed with Parole until retirement. Two things worked against me. Well, maybe more like three.
First, I have a big mouth and I seem to be unable to keep it shut, even when it would be politic to do so.
Second, I went to one little State Employees Union Meeting in Austin, talked to some legislators, on my OWN time and the Regional Supv was so paranoid after that... every time he called the office or my Unit Supv called him for something, he asked where I was. If I wasn't in the office, he assumed I was out doing "Union Business." I had to start bringing in Proof of where I had been, when I took comp time. A receipt from the Library, a local restaurant, a note from my kids, a copy of my travel sheet for the home visits, anything to prove I hadn't "snuck" down to Ft.Worth and the Union Office.
Third, my Unit Supervisor was a Bitch on Wheels. If I could have had the good luck to have kept the first Unit Sup I had...but that's water under the bridge. One evaluation from this woman would be glowing, the next would be awful, six months later...glowing...six months later...shit... This went on for FOUR years.
I had started volunteering with a non-profit about a year before I left Parole. They finally got a grant they had applied for and offered me a job. I jumped at the chance to get paid to do something I enjoyed and that I'd been doing for free. The fact that I'd be making the same money, working with co-workers who VALUED me and a client base who APPRECIATED me was as good, if not better than not having to take a salary cut.
I realize I have probably scared you away from Parole work. So I'll try to write a blog tomorrow telling you the things I LIKED about it. Believe it or not, there WERE some things I liked about being a Parole Officer.
However, a few months ago I exchanged email with a current Sex Offender P.O. and I spent several hours reading web page propaganda on the TDCJ site. I also spent a few years working for TDHS [TX Dept. of Human Services]. That's your first lesson, class. When you go to work for Uncle Sam or Uncle Sam Houston, be prepared to start learning a different language, the language of abbreviations.
I used to drive my kids and Mother NUTS talking in abbreviations. They hated that. I still lapse back in to that letter-speak from time to time. My Daughter, the English major, gets all uppity and makes snide remarks about wasting my education and fine vocabulary. I just smile inwardly, and bide my time. When she becomes a teacher she'll have her very own secret language from TEA and PTA et al.
Next on my list of warnings... it all depends on the Unit Supervisor you draw. The person who supervises you on a day to day basis can determine whether you have a successful or a shitty career. As can your ability to keep your head down and out of office politics. Listen very carefully to my next: ALL State Agencies, by their very existence and dependence upon the Lege for funding and their bureaucratic structure always have been and always will be political. Unless you can stay out of the politics, or you are an EXPERT political animal or you can survive having your ass handed to you by someone who IS a Political Predator...reconsider going to work for a State Agency. Or, try it for a year, and if things are working out, then you can try it for another year...but please don't start planning a career until you've lasted at least 5 years. If you have not risen to P.O. III, or Hearing Officer after five years...consider switching to Probation or the Feds.
The beginning salary and what you can expect after 2 years and then 5 years can be found by navigating through the link I gave you above. I will say it's more than what I was making when I left, 17 yrs ago, but that's to be expected after all this time, what with COLAs and the fact that they were literally bleeding new P.O.s for awhile. They had to increase salaries in an effort to keep them.
They induce the Type A P.O.s to take on the specialized caseloads that I discussed back in September [I think, maybe it was October] by appealing to their egos. "Oh, not just any P.O. can handle a caseload like this." "It takes a SPECIAL officer to handle the challenges of a caseload made up of these kinds of releasees." Do NOT fall for this trap!! I can't even believe they are still gettin' away with using that crap!
In 1988 I was one of the first Sex Offender Parole Officer Texas had. I was one of their guinea pigs. We went to Austin for a week in the Spring. Then in December we went to Padre Island for a week and that was what they called training. Of course we started seeing sex offender parolees right after we got back in the Spring. There wasn't then and isn't now a distinction made between Rapists and Pedophiles. However there is a world of difference in the way to approach those offenders, both because of the way their minds work and for officer safety reasons. BAD JuJu, very bad JuJu!
But the 'crats at the top of the heap at TDCJ-PPD have been gettin' away with connin' the best officers into workin' these high stress caseloads because they choose the officers who love a frickin' challenge. Oh, yes we do. [do I sound bitter? I get that way when my soul is sucked dry and the husk thrown away. I'm touchy about that.]
The workloads? Oh, lets see they are about 1/2 again as much as normal humans can handle during a 40 hour work-week. Of course there IS no such thing as OT when you work for the State. We used to be able to accumulate "Comp" time which we had to use in the same week we earned it. In other words, if you worked late on Tuesday because you had to do home visits, then you had to take the same number of hours off before 5 p.m. Friday or you just gave the State your time. However, if you got stuck with Friday as a "Duty Day" and had to be in the office that day and a bunch of parolees got released on Thursday and reported on Friday and their P.O.s were out and you had to see them instead as well as your own parolees who were there for their monthly report and you wound up working until 6 or 7 pm, well the entire TDCJ appreciated the donation of your time. I don't imagine that has changed either, but YMMV.[your mileage may vary]
I hope by now that they have switched to computerized records, but I doubt it. It is after all a State Bureaucracy. When I left, they were just getting computers. By now I'm sure every P.O. has a desktop and some may even have laptops for field use. BUT, and I hope I'm wrong, but I'd bet you $5 that officers, at a minimum, have to print off a copy of everything they put in the E-file and maintain a paper file, too. That's the bureaucratic mindset. If it's not on paper, it's not real.
In any case, every contact with or in connection with a releasee MUST be documented. Every phone call, every office, home and job site visit must be written in the case file. If the parolee goes to counselling, the documentation he brings in to prove to you he has attended and paid for his counselling must be noted and a copy placed in the file. His documentation for AA/NA must also be written in your notes and a copy placed in the file.
When I was still with Parole they were experimenting with having P.O.s collect and test urine samples from parolees. We had three different test kits so we could test for opiates, cocaine and marijuana. [BTW, you would have to eat a ridiculous amount of poppy seed hamburger buns, the BIG ones before your urine would test + for opiates, same for being in the same room where other people were smokin' dope and that's why you tested + for MaryJane. What? Were they super chargin' you? Go peddle that story somewhere else, cause I ain't senile so I'm not buyin' it.] Now when you submit your application for employment to the Human Resources folks, they don't warn you about this kind of stuff. My degree is in Social Work, not biology or chemistry. I most definitely did NOT sign on to carry some felon's hot pee around in a plastic cup and then run 3 tests on it, AFTER work hours when I should have been home with my kids or going out to dinner with that long, tall, gorgeous, hunk of man who is now my Dearly Beloved. So, you up for that, Pilgrim?
If I had been able to get OUT of my District Parole Office and become a hearing officer or get a transfer to Institutional Parole Officer, I probably would have stayed with Parole until retirement. Two things worked against me. Well, maybe more like three.
First, I have a big mouth and I seem to be unable to keep it shut, even when it would be politic to do so.
Second, I went to one little State Employees Union Meeting in Austin, talked to some legislators, on my OWN time and the Regional Supv was so paranoid after that... every time he called the office or my Unit Supv called him for something, he asked where I was. If I wasn't in the office, he assumed I was out doing "Union Business." I had to start bringing in Proof of where I had been, when I took comp time. A receipt from the Library, a local restaurant, a note from my kids, a copy of my travel sheet for the home visits, anything to prove I hadn't "snuck" down to Ft.Worth and the Union Office.
Third, my Unit Supervisor was a Bitch on Wheels. If I could have had the good luck to have kept the first Unit Sup I had...but that's water under the bridge. One evaluation from this woman would be glowing, the next would be awful, six months later...glowing...six months later...shit... This went on for FOUR years.
I had started volunteering with a non-profit about a year before I left Parole. They finally got a grant they had applied for and offered me a job. I jumped at the chance to get paid to do something I enjoyed and that I'd been doing for free. The fact that I'd be making the same money, working with co-workers who VALUED me and a client base who APPRECIATED me was as good, if not better than not having to take a salary cut.
I realize I have probably scared you away from Parole work. So I'll try to write a blog tomorrow telling you the things I LIKED about it. Believe it or not, there WERE some things I liked about being a Parole Officer.
Friday, January 4, 2008
Defining Depression
How do you know when the "Blues" have gotten out of hand and you need medication to be able to get past it?
Not related to post partum depression, just an over load of stress and crap in life. Is it possible to expect to get back off the medication some day?
If you don't have a GP, where do you start? I go to my OB/GYN annually for my medical needs.
This is probably one of the MOST common questions Social Workers, Doctors, Nurses, Nurse Practitioners, Counselors,Psychologists, and Psychiatrists hear.
Almost everybody gets the "Blues" from time to time. But there are definite signs and symptoms that differentiate the Blues from a Depression that can be treated with medication and/or therapy.
I need to take a detour here onto one of my famous tangents [if you read my other blog, you've been on one of my "Tangential Thinking Road Trips" before]. I am one of those helping professionals who believe that therapy never hurt anyone and has helped just about every one who gave it an honest try. So IF you meet the criteria for Depression, please consider therapy as well as medication.
I also attended the Nature and Nurture School of Causation for Depression. I think there is, in addition to the neurotransmitter/chemical imbalance component of depression, something in almost every one's background that contributed to their depression. Does this make you nuts? NO, it does not! Is it a criticism of your Mother or Daddy or the way they raised you? Not necessarily, unless you were abused physically, sexually, or emotionally. Or neglected physically or emotionally. The point is: YOU get to set the parameters for discussion in therapy. And, you can say ANYTHING within the confines of your therapist's office and it's confidential. Now, I know there may be a smart-ass or two out there to nit pick that last statement...so I have to include this modifier: if you tell your therapist you are planning to harm another person said therapist is obligated to inform the authorities and your intended victim [I think]. But that is the only time they are allowed to violate your confidentiality.
OK, side trip over, let's get back to the main topic...
I went to some websites I found through Ask.com, my search engine of choice, using Depression Symptoms as my search criteria. These come from the National Institutes of Mental Health website, http://www.nimh.nih.gov/health/publications/depression/complete-publication.shtml#pub3, just in case you want more info than what I'm relating here. I also liked their definition of Depression: When a person has a depressive disorder, it interferes with daily life, normal functioning, and causes pain for both the person with the disorder and those who care about him or her. Depression is a common but serious illness, and most who experience it need treatment to get better.
Not related to post partum depression, just an over load of stress and crap in life. Is it possible to expect to get back off the medication some day?
If you don't have a GP, where do you start? I go to my OB/GYN annually for my medical needs.
This is probably one of the MOST common questions Social Workers, Doctors, Nurses, Nurse Practitioners, Counselors,Psychologists, and Psychiatrists hear.
Almost everybody gets the "Blues" from time to time. But there are definite signs and symptoms that differentiate the Blues from a Depression that can be treated with medication and/or therapy.
I need to take a detour here onto one of my famous tangents [if you read my other blog, you've been on one of my "Tangential Thinking Road Trips" before]. I am one of those helping professionals who believe that therapy never hurt anyone and has helped just about every one who gave it an honest try. So IF you meet the criteria for Depression, please consider therapy as well as medication.
I also attended the Nature and Nurture School of Causation for Depression. I think there is, in addition to the neurotransmitter/chemical imbalance component of depression, something in almost every one's background that contributed to their depression. Does this make you nuts? NO, it does not! Is it a criticism of your Mother or Daddy or the way they raised you? Not necessarily, unless you were abused physically, sexually, or emotionally. Or neglected physically or emotionally. The point is: YOU get to set the parameters for discussion in therapy. And, you can say ANYTHING within the confines of your therapist's office and it's confidential. Now, I know there may be a smart-ass or two out there to nit pick that last statement...so I have to include this modifier: if you tell your therapist you are planning to harm another person said therapist is obligated to inform the authorities and your intended victim [I think]. But that is the only time they are allowed to violate your confidentiality.
OK, side trip over, let's get back to the main topic...
I went to some websites I found through Ask.com, my search engine of choice, using Depression Symptoms as my search criteria. These come from the National Institutes of Mental Health website, http://www.nimh.nih.gov/health/publications/depression/complete-publication.shtml#pub3, just in case you want more info than what I'm relating here. I also liked their definition of Depression: When a person has a depressive disorder, it interferes with daily life, normal functioning, and causes pain for both the person with the disorder and those who care about him or her. Depression is a common but serious illness, and most who experience it need treatment to get better.
Here are the symptoms:
Persistent sad, anxious or "empty" feelings
Feelings of hopelessness and/or pessimism
Feelings of guilt, worthlessness and/or helplessness
Irritability, restlessness
Loss of interest in activities or hobbies once pleasurable, including sex
Fatigue and decreased energy
Difficulty concentrating, remembering details and making decisions
Insomnia, early–morning wakefulness, or excessive sleeping
Overeating, or appetite loss
Thoughts of suicide, suicide attempts
Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment
As for the 2nd part of the writer's email: Where to start if you don't have a GP, or Primary Care Physician and only see an OB/Gyn once a year for Well Woman Check-ups? There are, in most communities, mental health resources even for people without insurance. I don't know where this particular person lives. In Texas, we have an agency known as Mental Health/Mental Retardation [how UN-PC of us!!] or MH/MR. They accept anybody. The charges will be based on your ability to pay. If you are employed, but have no insurance, the eligibility worker will look at your income, family size and other medical expenses. Your fee per service, both medicine and therapy will be based on a sliding scale.
But, if you have private insurance, you will need to check your individual plan's coverage and requirements before beginning therapy. They may require you to only see provider's from an approved group of professional with whom they have negotiated fees. Otherwise your benefits may be reduced.
When seeking a physician to prescribe anti-depressant medication, I think it's important to consult a psychiatrist. They are specialists. All they do is treat disorders like depression. Their expertise can be invaluable in choosing the right medication for you. Often a medication regimen must be tweaked over a period of time before finding the correct dosage or even the correct medicine or combination of medicines for a particular patient. This is not a process to be left in the hands of the physician who goes from room to room treating coughs one minute and a sprained ankle the next, and then someone else's hypertension.
Trust me on this, even if it costs a little extra for the co-pay, go to the Shrink. They know their stuff. And don't get discouraged if the first medicine doesn't work. Or if your dosage has to be increased. Or if it has to be changed after 6 or 9 or 12 months. These things happen in a large percentage of cases. Treating Depression isn't like treating an ear infection or bronchitis. It's not one medicine works for everybody.
In the last 32 years, I've been on at least 13 different anti-depressants. So I know what I'm talkin' about when I speak of tweaking doses and making other adjustments. The brain is an amazingly adaptable organ. You put one chemical into it long enough and it will accommodate that chemical to the point where you have to try another chemical to achieve the same balance of Serotonin and Norepinephrin [the two neurotransmitters that get out of whack when we're depressed].
I think I answered the questions. If anybody is still in doubt after this and going to the NIMH site, leave me a comment or send me another email and I'll take another shot at it.
Tomorrow I answer a question about being a Parole Officer by someone considering a Career change.
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