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Depression Comorbidities

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January 31, 2008

The Ultimate Sacrifice: US Army war soldiers are increasingly attempting or successfully committing suicide. It is indefensible.

Our national heroes are not getting the necessary mental health care and support to withstand the pressures of the war in Iraq. I find this indefensible.

Multiple new efforts aimed at stemming suicides in the Army are falling short of their goal: The service anticipates another jump in the annual number of soldiers who killed themselves or tried to, including in the Iraq and Afghanistan war zones. As many as 121 soldiers committed suicide in 2007, an increase of some 20 percent over 2006, according to preliminary figures released on January 31st.

The number who tried to commit suicide or injured themselves for some other reason jumped six-fold in the last several years - from 350 in 2002 to about 2,100 incidents last year. Officials said an unknown portion of that increase was likely due to use of a new electronic tracking system that is more thorough in capturing health data than the previous system.

The Army offered up a weak excuse: ""We have been perturbed by the rise despite all of our efforts," said Col. Elspeth Ritchie, psychiatry consultant to the Army surgeon general.

That has to be the understatment of the year! It's insulting to the soldiers, their loved ones and to all Americans.

"We know we've been doing a lot of training and education," Ritchie told a Pentagon press conference. "Clearly we need to be doing more."

Geez.

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The U.S. Food & Drug Administration: "Suicidal-Thoughts Risk Is Linked To Drugs Used to Treat Epilepsy

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Britney Spears has to follow all the same rules that anyone with an illness has to follow. There are no exceptions.

I am not an M.D,, so it I am not qualified to dispense  my advice specifically for Britney Spears. Maybe she has Bipolar depression, maybe not. But I do know that she has to follow the identical rules that th rest of us have to follow. Thankfully,

last night, Britney's new psychiatrist went to her home and felt she was a danger to herself and others -- partly because of her reckless driving and partly because of her "downhill behavior." As a result, the shrink launched a plan (days in the making) to have Britney committed to UCLA Medical Center by calling the cops.

Britney is just like any other mere mortal who has an illness. She needs:

  1. A full medical evaluation by appropriate physicians and mental health professionals
  2. An assessment
  3. A diagnosis and a
  4. TREATMENT PLAN

Finally she must strictly follow the directives of the treatment plan designed by her medical team. That is how I did it. That is how everyone else in the world has to do it. No exceptions.

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January 30, 2008

What is the average age when depression can be at its worst?

I thought this story was interesting because for me the answer to their question was just about the same as my answer. Thankfully, I was rescued from the spiral of depression at age 41 due vagus nerve stimulation therapy. According to a major worldwide study by Dartmouth College and the University of Warwick in Coventry England:

"Middle age ( i.e. age 44) makes you miserable, so don't blame your job, your kids, your spouse, your income or lack of it, suggests an international study of 2 million people from 80 nations released today. Researchers  from Great Britain and the USA analyzed data spanning more than 35 years on measures such as depression, anxiety, mental well-being, happiness and life satisfaction."

They found that men and women in their 40s were more likely to be depressed and weren't as happy as other ages. Middle age is such a low point for well-being that it's at the bottom of a U-shaped curve that indicates greater happiness among the young and old.

"It's midlife per se," says co-author Andrew Oswald, an economist at the University of Warwick in Coventry, England. "It's something deep beyond all the controls in our equation. It's a developing midlife low. It doesn't just happen one year and go away another."

The study by Oswald and fellow economist David Blanchflower of Dartmouth College in Hanover, N.H., being published in the journal Social Science & Medicine found the same U-shape by age for 72 of 80 countries studied.

"You can be almost certain you will follow this U-shaped curve," Oswald says. "If you are finding life tough in your 40s, maybe it's useful to know this is completely normal."

Despite some skepticism, Oswald says the age factor appears real.

"We're correlating mental well-being with age, having factored out 100 other influences," Oswald says."In 2008, social science can't do better than this."

Unfortunately, if you have treatment-resistant depression, the misery of hopelessness extends well beyond a "mid-life crisis." I wish it were that simple.

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January 29, 2008

The Oprah Winfrey Show recently discussed natural remedies for depression with Dr. Oz and a Harvard Professor of Psychiatry. I was skeptical.

Last week The Oprah Winfrey Show discussed natural remedies for depression with Dr. Mehmet Oz and David Mischoulon, M.D., Ph.D., professor of psychiatry at Harvard Medical School. Personally, I take a dim view of natural remedies for patients with severe depression. I had tried all of them and had absolutely no success. Also I think it trivializes a very serious biological illness.

According to Dr. David Mischoulon, researchers are uncovering evidence that suggests that certain natural remedies may be effective in treating depression. The doctors talked  about diagnoses and treatments for depression, including three over-the-counter remedies which may be beneficial to patients when used in conjunction with professional help.

The three remedies discussed were:

  1. Omega-3s: Dr. Mischoulon says preliminary studies have found that omega-3 fatty acids derived from fish oils (not flaxseed) may be effective for treating depression. Taking a daily supplement may have other benefits to cardiovascular health and has few or no known side effects, he says.
  2. St. John's Wort: Dr. Mischoulon says this plant-derived herbal remedy may be effective for treating particularly mild to moderate cases of depression.
  3. S-Adenosyl Methionine: SAM or SAM-e (pronounced "sammy") is a natural compound all mammals manufacture that may alleviate the symptoms of depression, Dr. Mischoulon says. "By taking SAM-e, that could [potentially] result in the brain synthesizing and having available greater levels of the important neurotransmitters and that could reverse a depressed state," he said.

    Buyer beware.

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January 27, 2008

Heath Ledger: a very lonesome cowboy, relaxed on the ranch but very nervous and anxious as a celebrity in the spotlight. His death is no "Joke"

Heath Ledger was relaxed in the peacefulness of the ranch when he played a gay cowboy in the movie Brokeback Mountain. Off the ranch, he clearly struggled with many complex issues. His friends and associates applauded him as being a wonderful kind person. But you can still be a "good guy" and struggle with drugs and addiction. Jack Nicholson, his co-star in the upcoming movie The Joker made a very insightful comment:

“There are too many around today who are lonely,” Nicholson said. “Film acting will drive you nuts – if you let it. You can get everything out there if you are young and famous. Any woman. Any drug. But you have to build up your safety zone. You’ve got to build up friendships and keep to them.

People who suffer from depression are loners. It is a coping mechanism. I think that the talking pundits are confusing his alledged "shyness" when indeed  he was suffering from depression. Isolation, social withdrawal and drug use are classic symptoms of depression.

Depression sufferers are all Acedamy Award winners. We have to fake it to make it. Heath Ledger took six different types of prescription drugs to treat anxiety, insomnia and antidepressants. His use of anti-anxiety medication helped mitigate his nervousness and  enabled him to make it through the day.

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Don't Suddenly Stop Taking an Antidepressant: learn about 7 symptoms you may experience if you stop too quickly

If you want to stop taking an antidepressant, it's important to speak with your doctor first, the American Academy of Family Physicians says. The doctor may recommend weaning your body off the medication gradually.

People who stop an antidepressant too quickly may trigger a host of symptoms that doctors call antidepressant discontinuation syndrome. Symptoms may include:

  • Anxiety.
  • Feelings of depression or sadness.
  • Moodiness and irritability.
  • Tiredness.
  • Headaches and dizziness.
  • Nausea and vomiting.
  • Diarrhea.

If an antidepressant is causing an unpleasant side effect, your doctor may opt to lower your dose or prescribe a different type of antidepressant altogether. I know that the entire trial and error process is a total drag. I have been there and back. But it is critical that you strictly follow you doctor's directives.

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January 23, 2008

Six different prescribed antidepressants, anti-anxiety medications, sleeping pills and one dead body: Heath Ledger and a Lifetime Academy Award

I am so very saddened by the death of Heath Ledger. I am particularly upset that he lived the last months of his life unhappy, anxious, exhausted   and depressed. According to New York City Police:

Six different types of prescription drugs were found in Heath Ledger's apartment — including anti-anxiety medications and sleeping pills — though the cause of his death won't be known for several days after a preliminary autopsy Wednesday came back inconclusive, authorities said.

The Australian-born actor was found dead Tuesday by his housekeeper and a massage therapist — lying naked and face-down on his bed, police said. The pills were found in bottles in Ledger's bedroom and bathroom, and police said the death was caused by a possible drug overdose and appeared to be accidental.

Ellen Borakove, a spokeswoman for the medical examiner's office, said that the autopsy on the 28-year-old actor was inconclusive and that more would be known in about 10 days, when more tests were completed.

I do not think that health 28-year old men die from the insomnia drug Ambien.
But Heath was an actor both on and off screen. I don't think this was an accidental death. All of Heath's friends said that "Ledger would be the last person to commit suicide", "he seemed so happy" and "that he lived a normal simple life."
Very few people ever say about a the suicide of a friend that "it was no surprise."
Regardless of how you label the death, sadly Mr. Heath, his talent and his modesty are no longer with us.

A Lifetime  Academy Award truly goes to Heath Ledger. May he rest in peace.


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January 22, 2008

Academy award nominee Heath Ledger ("Brokeback Mountain") found dead from an overdose of drugs.

This is another sad story of a celebrity who seem to have everything: fame, fortune and fans. Yet he had nothing with inner peace and happiness.

The star and Academy nominee for his role in the film Brokeback Mountain, Heath Ledger, was found dead today in his apartment in New York City due to a drug overdose. He was found by his housekeeper in his bedroom with pills strewn all over the room.

When paramedics responded, the actor was in full cardiac arrest. They attempted to perform CPR on him, but were unsuccessful. He was pronounced dead at the scene.

It's shocking and a tragedy, especially given that the gifted, handsome twenty-eight-year-old actor was a new father and with a new movie. He plays The Joker in the upcoming Batman film, "The Dark Knight". But he will always be best known groundbreaking role as Ennis in "Brokeback Mountain."

May he rest in peace.

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Battling the Bulge With Electricity: yet another potential involving the vagus nerve, the longest cranial nerve in the human body( averaging 25 inches)

Within a few years, Americans may have a new tool to fight back against obesity: electricity.

Not from the power grid, but from implanted pacemaker-like devices that influence a key nerve linked to food-related functions, including feelings of hunger and fullness. The quest for obesity-fighting drugs and devices is a tricky area where companies have stumbled before, and hacking into the nervous system can prove challenging. But it's also a potentially huge market given the prevalence of obesity and the scarcity of useful, low-impact treatments.

The company with the most attention-getting efforts here may be EnteroMedics Inc.

The St. Paul, Minn.-based company is testing an implantable device called Maestro that periodically blocks transmission on the digestion-controlling vagus nerve. Limited study data suggests it may trigger significant weight loss. A bigger, yearlong randomized study that's enrolling over the next six months could put the company on track for U.S. approval in the middle of 2010, if things go well.

If approved, the technology could give weight-loss surgeons a significant new tool.

A technology like this is dramatically safer than gastric bypass," said Scott Shikora, chief of bariatric surgery at the Tufts-New England Medical Center in Massachusetts, which will take part in the trial for Maestro.

By blocking the vagus nerve signals, Maestro may affect a host of systems to help patients shed weight, as suggested by limited studies thus far outside the United States. Among patents studied, EnteroMedics announced on Jan. 8 that nine device patients followed out to nine months had lost 29.5 percent of their excess weight.

Nothing about the all of the new ramifications involving the vagus nerve would shock me anymore. This could be a terrific discovery for the many Americans who Battle the Bulge.

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