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MENTAL ILLNESS l DIAGNOSIS l TREATMENT l RESEARCH

MENTAL ILLNESS


six

6% of Americans suffer from serious Mental Illnesses and
the latest statistics show that 1 in 4 are directly
or indirectly affected in some way.

Mental Illnesses are biological, medical brain disorders.
 Real Illnesses just like Diabetes. These illnesses include depression, schizophrenia, and bipolar disorder.

Mental Illness can strike at any age although it mostly occurs during adolescence and young adulthood.

THE GOOD NEWS: MENTAL ILLNESSES ARE TREATABLE.

Without treatment mental illnesses can erode a persons ability to function normally on a day to day basis.
The future bodes badly for the untreated sufferer.

Unemployment, homelessness, social isolation, violent actions, and suicide can ensue as the sufferer spirals downward. Confrontations with the criminal justice system and inappropriate incarceration are common.

Most sufferers of depression acknowledge its presence; however some sufferers believe that self-medication, alcohol, illegal drugs, etc are the answer.... Even suicide. NAMI concludes that in the United States the economic cost of untreated mental illness is more than 100 billion dollars each year.Some sufferers are untreated due to their lack of the 'where with all' or their inability to finance their treatment regimes. Others are jailed and left untreated, often not properly diagnosed.Many lack loving supporters. Sufferers released from hospital or treatment following enforced inpatient admission often have no motivation, intention or ability to continue with the treatment prescribed. Their treatment regime is not enforced. They are left to their own devices, and often as a consequence their illness re-surfaces. This subsequently leads them back to treatment forcibly. An unfortunate cycle and another waste of money and time?
A great many are in denial about their illness. That's an illness all by itself. Its called Anosognosia.
During Manic episodes individuals with Bi-Polar disease are unaware of their illness and usually consider themselves to be the ones not suffering. Its everyone else.......... With Schizophrenic sufferers it can be more acute.

THE GOOD NEWS: MENTAL ILLNESSES ARE TREATABLE. NAMI advocates that appropriate recognition and treatment (both emergency and follow up) of the mentally ill should be a basic right. Unwarranted financial and social barriers to treatment and the stigma attached should be eradicated without further delay.


The information above has been compiled from various websites and personal experiences and is not in anyway intended to replace or supercede any advice, diagnosis or treatment given by a qualified professional whose councel should be sought. In addition to the links to specific Mental Health related topics on the NAMI national website, the following links are recommended:

Anosognosia, take some time to watch this video:
Dr. Xavier Amador, author of "I Am Not Sick. I Don't Need Help"
.This organization provides volumes of useful information and further leads.Treatment Advocacy Center To find out more about specific illnesses visit the NAMI nationalBy IllnessGet more Mental Illness: Facts and Numbers from NAMI's Fact Sheet

MENTAL ILLNESS l DIAGNOSIS l TREATMENT l RESEARCH


DIAGNOSIS


Bipolar Disorder

What is bipolar disorder?


Reviewed by Ken Duckworth, MD, October 2006(NAMI NATIONAL)

 

Bipolar disorder, or manic depression, is a medical illness that causes extreme shifts in mood, energy, and functioning. These changes may be subtle or dramatic and typically vary greatly over the course of a person's life as well as among individuals. Over 10 million people in America have bipolar disorder, and the illness affects men and women equally. Bipolar disorder is a chronic and generally life-long condition with recurring episodes of mania and depression that can last from days to months that often begin in adolescence or early adulthood, and occasionally even in children. Most people generally require some sort of lifelong treatment. While medication is one key element in successful treatment of bipolar disorder, psychotherapy, support, and education about the illness are also essential components of the treatment process.

What are the symptoms of mania?

  • either an elated, happy mood or an irritable, angry, unpleasant mood
  • increased physical and mental activity and energy
    racing thoughts and flight of ideas
    talking, more rapid speech than normal
  • ambitious, often grandiose plans
  • risk taking
  • impulsive activity such as spending sprees, sexual indiscretion, and alcohol abuse
  • decreased sleep without experiencing fatigue
  • What are the symptoms of depression?

    Depression is the other phase of bipolar disorder. The symptoms of depression may include:

    What is a "mixed" state?

    A mixed state is when symptoms of mania and depression occur at the same time. During a mixed state depressed mood accompanies manic activation.

    What is rapid cycling?

    Sometimes individuals may experience an increased frequency of episodes. When four or more episodes of illness occur within a 12-month period, the individual is said to have bipolar disorder with rapid cycling. Rapid cycling is more common in women.

    What are the causes of bipolar disorder?

    While the exact cause of bipolar disorder is not known, most scientists believe that bipolar disorder is likely caused by multiple factors that interact with each other to produce a chemical imbalance affecting certain parts of the brain. Bipolar disorder often runs in families, and studies suggest a genetic component to the illness. A stressful environment or negative life events may interact with an underlying genetic or biological vulnerability to produce the disorder. There are other possible "triggers" of bipolar episodes: the treatment of depression with an antidepressant medication may trigger a switch into mania, sleep deprivation may trigger mania, or hypothyroidism may produce depression or mood instability. It is important to note that bipolar episodes can and often do occur without any obvious trigger.


    MENTAL ILLNESS l DIAGNOSIS l TREATMENT l RESEARCH

    Schizophrenia

    What is schizophrenia?
    Reviewed by Ken Duckworth, MD, October 2006 (NAMI NATIONAL)

    Schizophrenia is a serious and challenging medical illness, an illness that affects well over 2 million American adults, which is about 1 percent of the population age 18 and older.  Although it is often feared and misunderstood, schizophrenia is a treatable medical condition.

    Schizophrenia often interferes with a person's ability to think clearly, to distinguish reality from fantasy, to manage emotions, make decisions, and relate to others. The first signs of schizophrenia typically emerge in the teenage years or early twenties, often later for females. Most people with schizophrenia contend with the illness chronically or episodically throughout their lives, and are often stigmatized by lack of public understanding about the disease. Schizophrenia is not caused by bad parenting or personal weakness. A person with schizophrenia does not have a "split personality," and almost all people with schizophrenia are not dangerous or violent towards others while they are receiving treatment. The World Health Organization has identified schizophrenia as one of the ten most debilitating diseases affecting human beings.

    What are the symptoms of schizophrenia?

    No one symptom positively identifies schizophrenia. All of the symptoms of this illness can also be found in other mental illnesses. For example, psychotic symptoms may be caused by the use of illicit drugs, may be present in individuals with Alzheimer's disease, or may be characteristics of a manic episode in bipolar disorder. However, when a doctor observes the symptoms of schizophrenia and carefully assesses the history and the course of the illness over six months, he or she can almost always make a correct diagnosis.

    As with any other psychiatric diagnosis, it is important to have a good medical work-up to be sure the diagnosis is correct. Drug use can mimic the symptoms of schizophrenia and may also trigger vulnerability in individuals at risk. Other medical concerns also need to be ruled out before a correct diagnosis can be made.

    The symptoms of schizophrenia are generally divided into three categories -- Positive, Negative, and Cognitive:

     

    Schizophrenia also affects mood. While many individuals affected with schizophrenia become depressed, some also have apparent mood swings and even bipolar-like states.   When mood instability is a major feature of the illness, it is called schizoaffective disorder, meaning that elements of schizophrenia and mood disorders are prominently displayed by the same individual.   It is not clear whether schizoaffective disorder is a distinct condition or simply a subtype of schizophrenia.

     

    What are the causes of schizophrenia?

    Scientists still do not know the specific causes of schizophrenia, but research has shown that the brains of people with schizophrenia are different from the brains of people without the illness. Like many other medical illnesses such as cancer or diabetes, schizophrenia seems to be caused by a combination of problems including genetic vulnerability and environmental factors that occur during a person's development.Recent research has identified certain genes that appear to increase risk for schizophrenia.Like cancer and diabetes, the genes only increase the chances of becoming ill; they alone do not cause the illness.



    MENTAL ILLNESS l DIAGNOSIS l TREATMENT l RESEARCH


    TREATMENT

    How is bipolar disorder treated?

    Reviewed by Ken Duckworth, MD, October 2006 (NAMI NATIONAL)

    While there is no cure for bipolar disorder, it is a treatable and manageable illness. After an accurate diagnosis, most people can achieve an optimal level of wellness. Medication is an essential element of successful treatment for people with bipolar disorder. In addition, psychosocial therapies including cognitive-behavioral therapy, interpersonal therapy, family therapy, and psychoeducation are important to help people understand the illness and to internalize skills to cope with the stresses that can trigger episodes. Changes in medications or doses may be necessary, as well as changes in treatment plans during different stages of the illness.
    It is useful to know whether the "mood stabilizing medication" prescribed has been approved by the FDA for use in bipolar disorder:

    Medications for Mania:

    Currently FDA approved: lithium (Eskalith or Lithobid), divalproex sodium (Depakote), carbamazepine (Tegretol), olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon), aripiprazole (Abilify)
    At least one adequate well controlled study with positive data: haloperidol (Haldol)

    Medications for bipolar depression:

    Currently FDA approved: combination of olanzapine and fluoxetine (Symbyax)
    Also at least one adequate well controlled study with positive data: quetiapine (Seroquel) and lamotrigine (Lamictal)
    Medications for preventing (or delaying) recurrence:
    Currently FDA approved: lithium (Eskalith or Lithobid), lamotrigine (Lamictal), olanzapine (Zyprexa), and aripiprazole (Abilify) 
    Frequently a combination of two or more medications is used, especially during severe episodes of acute mania or depression.
    Medication specifics and possible side effects:

    Lithium

    has long been used as a first line treatment for acute mania in people with bipolar disorder for more than 50 years. It generally has more positive impact when used earlier, rather than later, in the course of bipolar disorder. Research shows it is most effective in those individuals with a family history of the illness, and in those experiencing the bipolar I sequence of swings between mania and depression with return to normal function between episodes.

    Like all medications, lithium treatment produces side effects. The most comm on ones are dose-related and can be effectively managed, but for about 30 percent of people who try it, lithium is not tolerable. Lithium side effects may include frequent urination, excessive thirst, weight gain, memory problems, hand tremors, gastrointestinal problems, hair loss, acne, and water retention. There are two important lithium side effects, that can be effectively monitored by a simple blood test: 1)hypothyroidism, which mimics depression and can be easily treated, and 2) less comm only, damage to kidney functions.

    Anti-convulsants:

    The Food and Drug Administration (FDA) approved divalproex sodium (Depakote) in 1995 for treating bipolar episodes. Originally approved in 1983 as a drug to treat epilepsy, Depakote was found to be as effective as lithium for treating acute mania, and appears to be better than lithium in treating the more complex bipolar subtypes of rapid cycling and dysphoric mania, as well as co-morbid substance abuse. In addition, Depakote may be safely given in larger doses to treat acute episodes, and works faster in this situation than lithium. The generic version of this drug is valproic acid. Some people find that the generic version produces more gastrointestinal distress than Depakote.

    Depakote may also produce sedation and gastrointestinal distress, but these side effects often resolve during the first six months of treatment, or with dose adjustment. Another dose-related side effect is weight gain, and rare liver and pancreatic function problems may develop while taking Depakote. However, Depakote is generally well-tolerated, and is now prescribed far more often then lithium. Recent controlled trials indicate that the combination of Depakote and lithium is more effective in preventing relapse and recurrence than treatment with lithium alone.

    Lamictal (lamotrigine), another anti-convulsant, is effective in the treatment of acute depression in bipolar I and II and in promoting remissions between episodes. For most people, Lamictal has a very tolerable side effect profile. Rarely, this medication can cause a rash serious enough to cause a medical emergency. The risk of this one potentially serious side effect can be reduced by starting with a low dose and going slowly in increasing the dose.

    Use of Antidepressants

    Standard antidepressant medications (those approved for the treatment of unipolar depression) have not yet been proven effective for bipolar depression. Although the evidence supporting their use for bipolar depression is limited to small or less rigorous studies, these medications remain the most comm only used treatment for bipolar depression. The data from larger studies finds neither evidence of benefit nor evidence that these agents cause large numbers of depressed patients to switch into mania.

    Use of Antipsychotic Medications as Mood Stabilizers

    To control acute episodes, antipsychotic medications may be used alone (monotherapy), or added to anti-convulsant medications (combination therapy). Medication guidelines now re commend the combination of these two medications as most effective for acute manic episodes. Because the older typical antipsychotic medications run the risk of causing permanent movement disorder, and have been associated with depression when used over the long term, the new atypical antipsychotics are now preferred for this purpose. All the new atypicals are effective in the treatment of acute and mixed mania. Olanzapine (Zyprexa) and risperidone (Risperdal) are FDA-approved for this purpose.

    Finding the right preventive/maintenance medicine is an art informed by science and your own observations. Not all medicines that work in the acute phase of mania are as strong in preventing the next episode, so this is an area to explore.

    Side effects of the atypicals are different than with first-generation antipsychotics (such as Haldol), although sedation, weight gain, and risk of diabetes are problems associated with many of the new antipsychotics. Clozapine and olanzapine, both effective antipsychotics and mood stabilizers, offer the most risk in this area. Weight gain is a serious clinical concern related to all atypical antipsychotics, and to anti-convulsants as well. Not only can weight gain lead to adult onset also known as type 2 diabetes and cardiovascular diseases, but being overweight is also now the leading cause of medication non-adherence. Doctors advise weekly monitoring of weight in the early stages of taking these medications, along with regular exercise and healthy diets, and people must be willing to make lifestyle changes to maintain optimal health. The FDA has noted an association between all atypical antipsychotics and the risk of diabetes. As the science develops in this area, it will continue to inform medicine choices for the person that best reflect their risks and benefits.


    How is schizophrenia treated?
    Reviewed by Ken Duckworth, MD, October 2006 (NAMI NATIONAL)

    While there is no cure for schizophrenia, it is a treatable and manageable illness. However, people sometimes stop treatment because of medication side effects, the lack of insight noted above, disorganized thinking, or because they feel the medication is no longer working. People with schizophrenia who stop taking prescribed medication are at risk of relapse into an acute psychotic episode. It's important to realize that the needs of the person with schizophrenia may change over time. Here are a few examples of supports and interventions:

    All medications have side effects.  Different medications produce different side effects, and people differ in the amount and severity of side effects they experience.  Side effects can often be treated by changing the dose of the medication, switching to a different medication, or treating the side effect directly with an additional medication.  NAMI's fact sheets on medications, developed by independent pharmacists, are a starting point to understand the risks and benefits of any individual medication.   Individuals thinking of starting or changing their medication should always gather good information, consider the risks and benefits, consult with their doctor and loved ones and work together to develop the most safe and effective treatment plan possible.

    Individuals with schizophrenia face enormous challenges, including society's stigmatization of people living with schizophrenia, and the discrimination that results from these prejudices.  Consider getting involved in NAMI, The National Alliance on Mental Illness, in order to contribute to and benefit from NAMI's core activities that support the NAMI mission: support, advocacy, education and improved research for this important and challenging condition.

     

    Reviewed by Ken Duckworth, MD, October 2006 (NAMI NATIONAL)


    MEDICATIONS PRESCRIBED FOR MENTAL ILLNESSES
    Comprehensive details of these medications can be found on the NAMI National website

    NAMI - About Medications
    Abilify (aripiprazole)
    Adderall (amphetamine)
    Ativan (lorazepam)
    BuSpar (buspirone)
    Celexa (citalopram hydrobromide)
    Clozaril (clozapine)
    Concerta (methylphenidate)
    Cymbalta (duloxetine)
    Depakote (divalproex)
    Effexor XR (venlafaxine)
    Fanapt (iloperidone)
    Geodon (ziprasidone)
    Haldol (haloperidol)
    Intuniv (guanfacine)
    Invega (paliperidone)
    Klonopin (clonazepam)
    Lamictal (lamotrigine)
    Latuda (lurasidone)
    Lexapro (escitalopram)
    Lithium
    Luvox (fluvoxamine)
    Paxil (paroxetine)
    Pristiq (desvenlafaxine succinate)
    Prolixin (fluphenazine)
    Prozac (fluoxetine)
    Remeron (mirtazepine)
    Risperdal (risperidone)
    Ritalin (methylphenidate)
    Saphris (asenapine)
    Seroquel (quetiapine)
    Strattera (atomoxetine)
    Symbyax (olanzapine/fluoxetine)
    Tegretol (carbamazepine)
    Topamax (Topiramate)
    Trileptal (oxcarbazepine)
    Vyvanse (Lisdexamfetamine)
    Wellbutrin (bupropion)
    Xanax (alprazolam)
    Zoloft (sertraline)
    Zyprexa (olanzapine)



    RESEARCH

    The study of brain disorders and severe mental illness is a continuous process:

    Here are some of the publications where advances are published:

    American Journal of Psychiatry

    Psychiatric Services

    Biological Psychiatry

    Journal of the American Academy of Child and Adolescent Psychiatry

    Archives of General Psychiatry

    © NAMI Manatee County is a non-profit, 501(c)(3) charitable organization. Donations to NAMI Manatee County are tax-deductible. Our Not-For-Profit exempt number is: EIN 59-3333-249

    The information contained in this web site is provided as a service to the Internet community, and does not constitute medical or any other type of professional advice. We try to provide quality information, but we make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this web site and its associates sites. As medical advice must be tailored to the specific circumstances of each individual, nothing provided herein should be used as a substitute for the advice of a competent medical professional.

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