Mind-body dualism seems alive and well in the land of mental health. I am still surprised how often someone will say, “well that’s not a biological depression.” Meaning that it is the kind of depression that can be understood as a result of events in that person’s life, or that it can be treated effectively with therapy, or that …
Winter Leads to Spring
Someone shared with us a wonderful video about John O’Donohue, a Celtic poet, philosopher and writer. In it we found this quote that resonated very much with our experience. It is about winter. And depression. And how life blossoms from the seeming dreariness of a period of fallowness. We think you might appreciate it. If you like this clip we …
Outcomes of Childhood Bipolar
What happens to children with bipolar disorder? Boris Birmaher, M.D., a professor of psychiatry at the University of Pittsburgh, and colleagues at UCLA and Brown University, followed 367 of children with the disorder for an average of eight years to find out. 45% of the subjects had had a stable mood for most of the follow-up period. Birmaher reported the findings at a …
Mania and Depression Aren’t Opposites
Recently I found myself thinking about the similarities between two mood states that appear to be extremely different: mania and depression. I was talking to a young man who is now quite depressed, and who was sharing with me his incredibly negative internal though processes. One of the things that he said caught my attention. He said he felt that his illness and …
Protected: Making Sense of Mental Illness in a Family Member
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Changing Hormone Levels and Mood
I was on the phone yesterday having an urgent consultation with a woman we have worked for 15 years. She has had a pretty straight forward history of depression and anxiety that we’ve treated primarily with antidepressants and cognitive behavioral therapy. She’s had a good response to this treatment approach. The two things about her depression that are a little …
Hardwiring Happiness
Sometimes it is simple ideas that resonate the most powerfully with our psyches. This week I have found myself, again and again, thinking about the fairly simple but quite elegantly described ideas in the book Hard Wiring Happiness. I should probably admit that I’ve only gotten about half way through the book, but even so, it has had quite an …
Acupuncture Works for Depression
A recent large study showed that accupuncture was helpful for depression when it was added on to usual care (which mostly involved antidepressants). 755 patients being treated in 27 primary-care clinics were randomly referred for accupuncture, humanistic counseling, or neither add-on treatment. The participants typically had moderately severe depression that was chronic (many of them had had depression since childhood). Both …
Fall Mania
I had been gearing up to write my usual set of posts about seasonal affective disorder, and then this afternoon I met with a young woman who has had a clear and consistent pattern of getting hypomanic in the fall. We talk a lot about winter and fall depression. And, for many people, as the days get shorter and darker …
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Depression is Something We Don’t Talk About
Here is a very thought provoking piece in the TED series about depression and stigma. Share it with others and tell me what you think. “If there is one thing that we need to do it is to accept that it is OK.” “We live in a world where if you break your arm everyone runs over to sign your …
Depression in Pregnancy Affects the Child
A new study reported in the latest issue of JAMA Psychiatry, suggests that a child “born to a woman who suffers depression during pregnancy stands a higher likelihood of becoming a depressed adolescent ….” The report used information from the Avon Longitudinal Study of Parents and Children, which has collected data from nearly 9,000 women and more than 4,500 adolescent children in …
Make Good on Parity
Today marks the 5th anniversary of the mental health parity bill which was to have ensured access to mental health services for all Americans with health insurance. Remarkably, the Obama administration has yet to issue the final regulations that will define how parity is implemented. In a very thoughtful piece published today in “The Hill” (a blog for lawmakers), former Representative …
Oxytocin and Maternal Depression
There is lots of interest these days in how maternal depression affects kids, and also in how to prevent those effects. Recent research has suggested that the hormone oxytocin may play an important role in what happens. A nice review of this literature appeared in the most recent issue of the American Journal of Psychiatry. The authors note that the …
Therapy for Anxiety in Bipolar
Anxiety is very common in people with bipolar moods. In fact, anxiety is typically the first sign of mental health problems (often it is present in childhood) for people who later develop bipolar. As a psychiatrist, I am aware that we have fewer useful long term treatments for anxiety in bipolar than we do for the mood swings of the …
A Deep Shadowy Fear
Most of us have had the feeling that, deep in the recesses of our brain, there lurks some terrible secret or event, some deeply frightening, or even terrifying memory or experience. For some of us there may, indeed, be a past trauma and a repressed childhood memory. But the rest of us are left to wonder, if nothing seems to …
Experience a Sense of Plenty
Nothing can seem more urgent, important, and real than the sense that there is not enough for us. Not enough love. Not enough food. The sense of scarcity may not even connect to any clear sense of what is missing. But that doesn’t take away its power. Regular readers of this blog know that we appreciate the insights of Rick …
Lithium, Bipolar and Creativity
A very talented writer who we’ve been seeing for about six months has noticed that her creativity seems to be way down. Creativity is a fundamental part of her view of herself. She is very upset. Her concern is that the lithium she has been taking might be the cause. However, she has been quite depressed for the last month. What …
Cognition Enhancing Apps
An experimental computer program is associated with improved attention and working memory in people over age 60, even 6 months after training. Somewhat fuzzy-brained after a poor night of sleep I ran across this summary of a paper that was just published in the prestigious scientific journal Nature (Anguera JA et al., Nature 2013 Sep 5; 501:97). Where could I test drive this application, …
But Hypomania is Great!
Sometimes I feel like the Grinch. This past week I found myself in the uncomfortable position of suggesting that it might be good to moderate the hypomania one of my patients was experiencing. I also got a somewhat frantic call from the therapist of another mutual patient, the therapist was asking, “how does this end… he really doesn’t want to …
Crossing Boundaries
An hour after I dictated a post about the complexity of working with patients with extreme moods. People whose moods may affect them so powerfully that a model of treatment that is purely based on the ethical principle of autonomy (I provide you with the information and you make the decisions about whether or not to seek treatment) doesn’t make …