Depression

Posted on April 10, 2016 by JmaC

Definition

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks.

Some forms of depression are slightly different, or they may develop under unique circumstances, such as:

  • Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.
  • Perinatal depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with perinatal depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany perinatal depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.
  • Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.
  • Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.
  • Bipolar Disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.”

Examples of other types of depressive disorders newly added to the diagnostic classification of DSM- 5 include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD).

Signs and Symptoms

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Irritability
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Feeling restless or having trouble sitting still
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early-morning awakening, or oversleeping
  • Appetite and/or weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.

Risk Factors

Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors.

Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.

Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.

Risk factors include:

  • Personal or family history of depression
  • Major life changes, trauma, or stress
  • Certain physical illnesses and medications

Treatment and Therapies

Depression, even the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.

Quick Tip: No two people are affected the same way by depression and there is no “one-size-fits-all” for treatment. It may take some trial and error to find the treatment that works best for you.

Medications

Antidepressants are medicines that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.

Antidepressants take time – usually 2 to 4 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before reaching a conclusion about its effectiveness. If you begin taking antidepressants, do not stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your doctor have decided it is time to stop the medication, usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.

Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.

If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding, talk to your doctor about any increased health risks to you or your unborn or nursing child.

To find the latest information about antidepressants, talk to your doctor and visit www.fda.gov .

You may have heard about an herbal medicine called St. John’s wort. Although it is a top-selling botanical product, the FDA has not approved its use as an over-the-counter or prescription medicine for depression, and there are serious concerns about its safety (it should never be combined with a prescription antidepressant) and effectiveness. Do not use St. John’s wort before talking to your health care provider. Other natural products sold as dietary supplements, including omega-3 fatty acids and S-adenosylmethionine (SAMe), remain under study but have not yet been proven safe and effective for routine use. For more information on herbal and other complementary approaches and current research, please visit the National Center for Complementary and Integrative Health  website.

Psychotherapies

Several types of psychotherapy (also called “talk therapy” or, in a less specific form, counseling) can help people with depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy. More information on psychotherapy is available on the NIMH website and in the NIMH publication Depression: What You Need to Know.

Brain Stimulation Therapies

If medications do not reduce the symptoms of depression, electroconvulsive therapy (ECT) may be an option to explore. Based on the latest research:

  • ECT can provide relief for people with severe depression who have not been able to feel better with other treatments.
  • Electroconvulsive therapy can be an effective treatment for depression. In some severe cases where a rapid response is necessary or medications cannot be used safely, ECT can even be a first-line intervention.
  • Once strictly an inpatient procedure, today ECT is often performed on an outpatient basis. The treatment consists of a series of sessions, typically three times a week, for two to four weeks.
  • ECT may cause some side effects, including confusion, disorientation, and memory loss. Usually these side effects are short-term, but sometimes memory problems can linger, especially for the months around the time of the treatment course. Advances in ECT devices and methods have made modern ECT safe and effective for the vast majority of patients. Talk to your doctor and make sure you understand the potential benefits and risks of the treatment before giving your informed consent to undergoing ECT.
  • ECT is not painful, and you cannot feel the electrical impulses. Before ECT begins, a patient is put under brief anesthesia and given a muscle relaxant. Within one hour after the treatment session, which takes only a few minutes, the patient is awake and alert.

Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). Other types of brain stimulation treatments are under study. You can learn more about these therapies on the NIMH Brain Stimulation Therapies webpage.

If you think you may have depression, start by making an appointment to see your doctor or health care provider. This could be your primary care practitioner or a health provider who specializes in diagnosing and treating mental health conditions. Visit the NIMH Find Help for Mental Illnesses if you are unsure of where to start.

Beyond Treatment: Things You Can Do

Here are other tips that may help you or a loved one during treatment for depression:

  • Try to be active and exercise.
  • Set realistic goals for yourself.
  • Try to spend time with other people and confide in a trusted friend or relative.
  • Try not to isolate yourself, and let others help you.
  • Expect your mood to improve gradually, not immediately.
  • Postpone important decisions, such as getting married or divorced, or changing jobs until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
  • Continue to educate yourself about depression.

Join a Study

What are Clinical Trials?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including depression. During clinical trials, some participants receive treatments under study that might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. Other participants (in the “control group”) receive a standard treatment, such as a medication already on the market, an inactive placebo medication,  or no treatment. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Please Note: Decisions about whether to participate in a clinical trial, and which ones are best suited for a given individual, are best made in collaboration with your licensed health professional.

How do I find a Clinical Trials at NIMH on Depression?

Doctors at NIMH are dedicated to mental health research, including clinical trials of possible new treatments as well as studies to understand the causes and effects of depression. The studies take place at the NIH Clinical Center in Bethesda, Maryland and require regular visits. After the initial phone interview, you will come to an appointment at the clinic and meet with one of our clinicians. Find NIMH studies currently recruiting participants with depression by visiting Join a Research Study: Depression.

How Do I Find a Clinical Trial Near Me?

To search for a clinical trial near you, you can visit ClinicalTrials.gov . This is a searchable registry and results database of federally and privately supported clinical trials conducted in the United States and around the world (search: depression). ClinicalTrials.gov gives you information about a trial’s purpose, who may participate, locations, and contact information for more details. This information should be used in conjunction with advice from health professionals.

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Borderline Personality Disorder

Posted on April 10, 2016 by JmaC

What is Borderline Personality Disorder?

Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, theDiagnostic and Statistical Manual for Mental Disorders, Third Edition(DSM-III) listed BPD as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses.

Because some people with severe BPD have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders. While mental health experts now generally agree that the name “borderline personality disorder” is misleading, a more accurate term does not exist yet.

Most people who have BPD suffer from:

  • Problems with regulating emotions and thoughts
  • Impulsive and reckless behavior
  • Unstable relationships with other people.

People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides.

Causes

Research on the possible causes and risk factors for BPD is still at a very early stage. However, scientists generally agree that genetic and environmental factors are likely to be involved.

Studies on twins with BPD suggest that the illness is strongly inherited. Another study shows that a person can inherit his or her temperament and specific personality traits, particularly impulsiveness and aggression. Scientists are studying genes that help regulate emotions and impulse control for possible links to the disorder.

Social or cultural factors may increase the risk for BPD. For example, being part of a community or culture in which unstable family relationships are common may increase a person’s risk for the disorder. Impulsiveness, poor judgment in lifestyle choices, and other consequences of BPD may lead individuals to risky situations. Adults with borderline personality disorder are considerably more likely to be the victim of violence, including rape and other crimes.

Signs & Symptoms

According to the DSM, Fourth Edition, Text Revision (DSM-IV-TR), to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following symptoms:

  • Extreme reactions—including panic, depression, rage, or frantic actions—to abandonment, whether real or perceived
  • A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
  • Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices)
  • Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
  • Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
  • Intense and highly changeable moods, with each episode lasting from a few hours to a few days
  • Chronic feelings of emptiness and/or boredom
  • Inappropriate, intense anger or problems controlling anger
  • Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.

Seemingly mundane events may trigger symptoms. For example, people with BPD may feel angry and distressed over minor separations—such as vacations, business trips, or sudden changes of plans—from people to whom they feel close. Studies show that people with this disorder may see anger in an emotionally neutral face and have a stronger reaction to words with negative meanings than people who do not have the disorder.

Suicide and Self-harm

Self-injurious behavior includes suicide and suicide attempts, as well as self-harming behaviors, described below. As many as 80 percent of people with BPD have suicidal behaviors, and about 4 to 9 percent commit suicide.

Suicide is one of the most tragic outcomes of any mental illness. Some treatments can help reduce suicidal behaviors in people with BPD. For example, one study showed that dialectical behavior therapy (DBT) reduced suicide attempts in women by half compared with other types of psychotherapy, or talk therapy. DBT also reduced use of emergency room and inpatient services and retained more participants in therapy, compared to other approaches to treatment.

Unlike suicide attempts, self-harming behaviors do not stem from a desire to die. However, some self-harming behaviors may be life threatening. Self-harming behaviors linked with BPD include cutting, burning, hitting, head banging, hair pulling, and other harmful acts. People with BPD may self-harm to help regulate their emotions, to punish themselves, or to express their pain. They do not always see these behaviors as harmful.

Who Is At Risk?

According to data from a subsample of participants in a national survey on mental disorders, about 1.6 percent of adults in the United States have BPD in a given year.  BPD usually begins during adolescence or early adulthood. Some studies suggest that early symptoms of the illness may occur during childhood.

Diagnosis

Unfortunately, BPD is often underdiagnosed or misdiagnosed.

A mental health professional experienced in diagnosing and treating mental disorders—such as a psychiatrist, psychologist, clinical social worker, or psychiatric nurse—can detect BPD based on a thorough interview and a discussion about symptoms. A careful and thorough medical exam can help rule out other possible causes of symptoms.

The mental health professional may ask about symptoms and personal and family medical histories, including any history of mental illnesses. This information can help the mental health professional decide on the best treatment. In some cases, co-occurring mental illnesses may have symptoms that overlap with BPD, making it difficult to distinguish borderline personality disorder from other mental illnesses. For example, a person may describe feelings of depression but may not bring other symptoms to the mental health professional’s attention.

Women with BPD are more likely to have co-occurring disorders such as major depression, anxiety disorders, or eating disorders. In men, BPD is more likely to co-occur with disorders such as substance abuse or antisocial personality disorder. According to the NIMH-funded National Comorbidity Survey Replication—the largest national study to date of mental disorders in U.S. adults—about 85 percent of people with BPD also meet the diagnostic criteria for another mental illness. Other illnesses that often occur with BPD include diabetes, high blood pressure, chronic back pain, arthritis, and fibromyalgia. These conditions are associated with obesity, which is a common side effect of the medications prescribed to treat BPD and other mental disorders.

No single test can diagnose BPD. Scientists funded by NIMH are looking for ways to improve diagnosis of this disorder. One study found that adults with BPD showed excessive emotional reactions when looking at words with unpleasant meanings, compared with healthy people. People with more severe BPD showed a more intense emotional response than people who had less severe BPD.

Treatments

BPD is often viewed as difficult to treat. However, recent research shows that BPD can be treated effectively, and that many people with this illness improve over time.

BPD can be treated with psychotherapy, or “talk” therapy. In some cases, a mental health professional may also recommend medications to treat specific symptoms. When a person is under more than one professional’s care, it is essential for the professionals to coordinate with one another on the treatment plan.

The treatments described below are just some of the options that may be available to a person with BPD. However, the research on treatments is still in very early stages. More studies are needed to determine the effectiveness of these treatments, who may benefit the most, and how best to deliver treatments.

Psychotherapy

Psychotherapy is usually the first treatment for people with BPD. Current research suggests psychotherapy can relieve some symptoms, but further studies are needed to better understand how well psychotherapy works.

It is important that people in therapy get along with and trust their therapist. The very nature of BPD can make it difficult for people with this disorder to maintain this type of bond with their therapist.

Types of psychotherapy used to treat BPD include the following:Cognitive behavioral therapy (CBT). CBT can help people with BPD identify and change core beliefs and/or behaviors that underlie inaccurate perceptions of themselves and others and problems interacting with others. CBT may help reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors.

  1. Dialectical behavior therapy (DBT). This type of therapy focuses on the concept of mindfulness, or being aware of and attentive to the current situation. DBT teaches skills to control intense emotions, reduces self-destructive behaviors, and improves relationships. This therapy differs from CBT in that it seeks a balance between changing and accepting beliefs and behaviors.
  2. Schema-focused therapy. This type of therapy combines elements of CBT with other forms of psychotherapy that focus on reframing schemas, or the ways people view themselves. This approach is based on the idea that BPD stems from a dysfunctional self-image—possibly brought on by negative childhood experiences—that affects how people react to their environment, interact with others, and cope with problems or stress.

Therapy can be provided one-on-one between the therapist and the patient or in a group setting. Therapist-led group sessions may help teach people with BPD how to interact with others and how to express themselves effectively.

One type of group therapy, Systems Training for Emotional Predictability and Problem Solving (STEPPS), is designed as a relatively brief treatment consisting of 20 two-hour sessions led by an experienced social worker. Scientists funded by NIMH reported that STEPPS, when used with other types of treatment (medications or individual psychotherapy), can help reduce symptoms and problem behaviors of BPD, relieve symptoms of depression, and improve quality of life. The effectiveness of this type of therapy has not been extensively studied.

Families of people with BPD may also benefit from therapy. The challenges of dealing with an ill relative on a daily basis can be very stressful, and family members may unknowingly act in ways that worsen their relative’s symptoms.

Some therapies, such as DBT-family skills training (DBT-FST), include family members in treatment sessions. These types of programs help families develop skills to better understand and support a relative with BPD. Other therapies, such as Family Connections, focus on the needs of family members. More research is needed to determine the effectiveness of family therapy in BPD. Studies with other mental disorders suggest that including family members can help in a person’s treatment.

Other types of therapy not listed in this booklet may be helpful for some people with BPD. Therapists often adapt psychotherapy to better meet a person’s needs. Therapists may switch from one type of therapy to another, mix techniques from different therapies, or use a combination therapy. For more information see the NIMH website section onpsychotherapy.

Some symptoms of BPD may come and go, but the core symptoms of highly changeable moods, intense anger, and impulsiveness tend to be more persistent. People whose symptoms improve may continue to face issues related to co-occurring disorders, such as depression or post-traumatic stress disorder. However, encouraging research suggests that relapse, or the recurrence of full-blown symptoms after remission, is rare. In one study, 6 percent of people with BPD had a relapse after remission.

Medications

No medications have been approved by the U.S. Food and Drug Administration to treat BPD. Only a few studies show that medications are necessary or effective for people with this illness. However, many people with BPD are treated with medications in addition to psychotherapy. While medications do not cure BPD, some medications may be helpful in managing specific symptoms. For some people, medications can help reduce symptoms such as anxiety, depression, or aggression. Often, people are treated with several medications at the same time, but there is little evidence that this practice is necessary or effective.

Medications can cause different side effects in different people. People who have BPD should talk with their prescribing doctor about what to expect from a particular medication.

Other Treatments

Omega-3 fatty acids. One study done on 30 women with BPD showed that omega-3 fatty acids may help reduce symptoms of aggression and depression. The treatment seemed to be as well tolerated as commonly prescribed mood stabilizers and had few side effects. Fewer women who took omega-3 fatty acids dropped out of the study, compared to women who took a placebo (sugar pill).

With proper treatment, many people experience fewer or less severe symptoms. However, many factors affect the amount of time it takes for symptoms to improve, so it is important for people with BPD to be patient and to receive appropriate support during treatment.

Living With

Some people with BPD experience severe symptoms and require intensive, often inpatient, care. Others may use some outpatient treatments but never need hospitalization or emergency care. Some people who develop this disorder may improve without any treatment.

How can I help a friend or relative who has BPD?

If you know someone who has BPD, it affects you too. The first and most important thing you can do is help your friend or relative get the right diagnosis and treatment. You may need to make an appointment and go with your friend or relative to see the doctor. Encourage him or her to stay in treatment or to seek different treatment if symptoms do not appear to improve with the current treatment.

To help a friend or relative you can:

Offer emotional support, understanding, patience, and encouragement—change can be difficult and frightening to people with BPD, but it is possible for them to get better over time

  • Learn about mental disorders, including BPD, so you can understand what your friend or relative is experiencing
  • With permission from your friend or relative, talk with his or her therapist to learn about therapies that may involve family members, such as DBT-FST.

Never ignore comments about someone’s intent or plan to harm himself or herself or someone else. Report such comments to the person’s therapist or doctor. In urgent or potentially life-threatening situations, you may need to call the police.

How can I help myself if I have BPD?

Taking that first step to help yourself may be hard. It is important to realize that, although it may take some time, you can get better with treatment.

To help yourself:

  • Talk to your doctor about treatment options and stick with treatment
  • Try to maintain a stable schedule of meals and sleep times
  • Engage in mild activity or exercise to help reduce stress
  • Set realistic goals for yourself
  • Break up large tasks into small ones, set some priorities, and do what you can, as you can
  • Try to spend time with other people and confide in a trusted friend or family member
  • Tell others about events or situations that may trigger symptoms
  • Expect your symptoms to improve gradually, not immediately
  • Identify and seek out comforting situations, places, and people
  • Continue to educate yourself about this disorder.

Clinical Trials

NIMH supports research studies on mental health and disorders. See also: A Participant’s Guide to Mental Health Clinical Research.

Participate, refer a patient or learn about results of studies inClinicalTrials.gov , the NIH/National Library of Medicine’s registry of federally and privately funded clinical trials for all disease.

Find NIH-funded studies currently recruiting participants with BPD. 

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Getting Reasonable Accommodations at work Before Stage 4

Posted on April 10, 2016 by JmaC

By: Nathaniel Z. Counts, J.D., Director of Policy, Mental Health America, and Aaron Konopasky, J.D., Ph.D., Senior Attorney-Advisor, Equal Employment Opportunity Commission

At Mental Health America (MHA), we work to make sure people can get help Before Stage 4. When we think of cancer or heart disease, we don’t wait years to treat people. We start before Stage 4—we begin with prevention, identify symptoms, and develop a plan to treat and support the person. We need to do the same with mental health.

When you think of acting Before Stage 4, you might think of going to see a therapist as soon as you notice problems with your mental health. This is an important part of acting Before Stage 4. But acting early to change your day-to-day experiences at work can be another important part.  For example, if you are distracted because of anxiety or depression, a quiet workspace might help you be more productive and happy, and ultimately support your recovery.  Or, if your therapist only has appointments on weekday mornings, a shift in your schedule might help.

But isn’t it up to your boss whether you have a quiet workspace or a later schedule?

Not always.  Sometimes, your employer is legally required to make changes that you need because of a mental health condition.  The Americans with Disabilities Act, or ADA, says that many people with common mental health conditions like major depression, PTSD, and OCD have the right to get “reasonable accommodations” at work.  A reasonable accommodation can be almost anything – getting detailed instructions on assignments, a white noise machine/headphones, or even permission to work from home in some cases – as long as it doesn’t involve significant difficulty or expense, or paying for work that isn’t done.  Not everyone with a mental health condition has the right to get reasonable accommodations, but if the condition is affecting your work, there’s a good chance you qualify.

Too often we think of asking for a reasonable accommodation as a last resort, because it could be risky to tell the boss about a mental health condition.  But there is also a risk in not telling, if a reasonable accommodation would help you to avoid mistakes that get you in trouble or even fired.  And, in addition to requiring reasonable accommodations, the ADA also makes it illegal to discriminate on the basis of disability.

MHA hopes to bring our Before Stage 4 philosophy to the workplace. For additional resources, visit MHA’s workplace wellness site, use our Work Health Survey, and take our mental health screens. Each is designed to help you think about how you can act Before Stage 4.

For additional information on reasonable accommodations, you can also check out thesepublications by the Job Accommodation Network.  To learn more about the law of reasonable accommodation, and what to do if you think your employer isn’t following the law, you can visit theEqual Employment Opportunity Commission (“EEOC”) website.  The EEOC also has a Fact Sheetthat you can give to your psychologist, psychiatrist, or other mental health provider that explains how they can help you get reasonable accommodations.

Note: This is intended to be an informal discussion, and should not be interpreted as an official position of the Equal Employment Opportunity Commission.

 

Get timely news letters and on line support board with chat rooms @ http://www.mentalhealthsupportcommunity.com

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ADHD Dialectical Behavior Therapy Skills Training Is Effective Intervention

Posted on April 10, 2016 by JmaC

March 31, 2016 | Special Reports, ADHD, Bipolar Disorder, Eating Disorders, Major Depressive Disorder, Personality Disorders
By Melanie S. Harned, PhD and Yevgeny Botanov, PhD
Linked Articles
The Neurobiology of Borderline Personality Disorder
Dialectical Behavior Therapy Skills Training Is Effective Intervention
Mentalization-Based Treatment: A Common-Sense Approach to Borderline Personality Disorder
The 4 treatment modes of standard dialectical behavior therapy
Figure 1. The 4 treatment modes of standard dialectical behavior therapy
DBT skills training: 4 sets of primary skills
Figure 2 . DBT skills training: 4 sets of primary skills
Dialectical behavior therapy (DBT) is a comprehensive, modular, cognitive-behavioral treatment that was originally developed to treat chronically suicidal individuals with complex clinical presentations and is best known as a treatment for borderline personality disorder. Meta-analyses have identified standard DBT as the most studied treatment available for borderline personality disorder and suicidal behavior, and DBT is widely recommended as a front-line treatment for these problems in professional guidelines.1-4
Standard DBT is typically delivered as a 1-year outpatient treatment modality with 4 modes (Figure 1). Standard DBT has primarily been evaluated as a treatment for individuals with borderline personality disorder. In this setting, it significantly decreases suicide-related outcomes (eg, suicide attempts, non-suicidal self-injury, suicide ideation), psychiatric hospitalization, use of emergency services, treatment discontinuation, depression, and substance use; it also increases social and global functioning.

DBT skills training

DBT skills training is typically delivered in a group format to target the enhancement of patient capabilities. Specifically, the primary focus is teaching patients a set of behavioral skills and strengthening their ability to use those skills in their everyday lives (Figure 2).

In standard DBT, it takes 24 weeks to get through the full skills curriculum, which is often repeated to create a 1-year treatment program. Detailed descriptions of the skills and the structure of standard DBT skills training groups can be found in the recently revised DBT skills training manual and accompanying patient workbook.5,6

DBT assumes that many of the problems exhibited by patients are caused by skills deficits. In particular, the failure to use effective behavior when it is needed is often a result of not knowing skillful behavior or when or how to use it. For example, deficits in emotion regulation skills are believed to be a core problem in individuals with borderline personality disorder, and these deficits result in maladaptive behaviors to regulate emotions (eg, suicide attempts, non-suicidal self-injury, substance use). Consistent with this skills deficit model, the use of DBT skills during standard DBT and DBT skills training has been found to fully or partially mediate improvements in suicidal behavior, non-suicidal self-injury, depression, anger control, emotion dysregulation, and anxiety.

A recent analysis evaluated the importance of the skills training component of DBT. Interventions that included skills training were found to be more effective in re­ducing non-suicidal self injury, depression, and anxiety.7 Taken together, these findings suggest that DBT skills are both a mechanism of change and a critical treatment component.

In clinical practice, DBT skills training has often been offered as a stand-alone or adjunctive intervention in settings where a comprehensive DBT program is not feasible or appropriate. Until recently, however, there was little research to support the use of DBT skills training separate from standard DBT or to guide clinicians in how to structure these interventions. DBT skills training interventions have now been evaluated in 13 published and peer-reviewed randomized clinical trials that have varied widely in the clinical population targeted, the duration of treatment, the specific skills taught, the degree to which skills were adapted, and the use of adjunctive treatment components. Emotion regulation and mindfulness are the most commonly taught skills modules, while interpersonal effectiveness is the most likely to be omitted. In addition, many studies included only a subset of skills within a larger module (see the DBT® Skills Training Manual,5 pages 110 to 122, for detailed skills curricula).

In these studies, DBT skills training interventions have improved a variety of conditions. (Monthly updates on the latest DBT research can be found on the Linehan Institute website: http://www.linehaninstitute.org/latestResearch.)
Disordered eating. Four trials have evaluated DBT skills training interventions for individuals with eating disorders, including binge eating disorder, chronic binging and purging, and subthreshold bulimia nervosa.8-11 Participants who received DBT skills training had greater reductions in binge eating or binge/purge behaviors than wait list controls and those in an active therapy group. In addition, DBT skills training was superior to active and non-active control therapy in reducing other types of eating-related pathology, including weight-related concerns, urges to eat when angry, eating restraint, eating concerns, preoccupation with food, and appetite awareness.

Mood disorders. Three trials have examined the efficacy of DBT skills training for individuals with MDD or bipolar I or II disorder. Harley and colleagues12 found significantly greater improvement among patients with treatment-resistant depression on stable antidepressant medication regimens who received DBT skills training compared with those on a wait list. A second study compared DBT skills training with antidepressant medication in a group of persons aged 60 years and older with MDD.13 The interventions were comparably effective in reducing depression at the end of treatment (28 weeks). Significant differences in favor of DBT skills training emerged at 6-month follow-up on clinician-rated depression remission rates. A third trial compared DBT skills training with a wait list for individuals with bipolar I or II disorder and found nonsignificant trends that favored DBT in reducing depression and mania.14

Several trials have also evaluated the effect of DBT skills training on depression severity in samples selected for other primary problems. Four studies found DBT skills training to be superior to active and non-active control therapy in reducing depression among individuals with borderline personality disorder, subthreshold bulimia nervosa, and childhood abuse histories.7,8,15,16 Two trials did not find differences between DBT skills training and active treatment controls in reducing depression among persons with high levels of emotion dysregulation and binge eating disorder.10,17

Anxiety. No studies have evaluated DBT skills training interventions for primary anxiety disorder. However, several studies have found DBT skills training to be more effective than active treatment controls in reducing anxiety severity among individuals with borderline personality disorder, high levels of emotion dysregulation, and a history of childhood abuse.15-17 In addition, a component analysis found that DBT interventions that included a skills training component were more effective than those without skills training in reducing anxiety severity among suicidal and self-injuring individuals with borderline personality disorder.7

ADHD. Two studies that used active treatment controls demonstrated the effectiveness of DBT skills training for attentional difficulties. In the earlier trial, DBT skills training led to a greater reduction of ADHD symptoms than a semistructured discussion group for individuals who maintained a stable medication regimen and completed treatment.18 A recent study of college students compared skills training with self-study handouts.19 Symptoms of inattention were significantly reduced in the DBT group by the end of follow-up; mindfulness and quality of life improvements were evident at the end of treatment, and improvement in mindfulness persisted through the follow-up period.

Borderline personality disorder. Two trials have evaluated DBT skills training interventions among persons with borderline personality disorder. Soler and colleagues15 compared 3 months of a stand-alone DBT skills training group to standard group therapy for individuals with moderate to severe borderline personality disorder. The results demonstrated the superiority of DBT skills training in reducing treatment dropout, depression, anxiety, general psychiatric symptoms, anger, feelings of emptiness, and emotional instability. The 2 treatments did not differ in their effect on global borderline personality disorder severity, suicide attempts, non-suicidal self-injury, or emergency department visits.

A recent component analysis compared the efficacy of 1 year of standard DBT, DBT group skills training with individual case management, and DBT individual therapy with an activities group for suicidal and self-injuring women with borderline personality disorder.7 All 3 treatments resulted in similar improvements in suicide-related outcomes (attempts, ideation, use of crisis services due to suicidality, and reasons for living). The treatment conditions that included skills training (standard DBT and DBT group skills training plus case management) were superior to DBT individual therapy in reducing non-suicidal self-injury, depression, and anxiety. There were no significant differences between standard DBT and DBT group skills training plus case management conditions, although there were trends in favor of standard DBT for treatment retention and follow-up year suicide attempts and use of crisis services.

Summary

The available research suggests that DBT skills training is a critical component and mechanism of action in DBT and can be effective as a stand-alone or adjunctive intervention for a variety of conditions. The strongest evidence exists for brief DBT skills training as a stand-alone intervention for binge eating disorder and bulimia nervosa. In addition, moderate evidence exists for the efficacy of brief DBT skills training as an adjunctive intervention to antidepressant medication for individuals with MDD, as well as a stand-alone intervention for ADHD. Two trials have shown promising results for DBT skills training for borderline personality disorder, but the findings require replication because of the notable differences between trials in treatment length, the use of adjunctive treatment components, and the severity of illness.

Additional research with larger samples and consistent DBT skills training curricula is needed to draw firm conclusions. Nevertheless, the effectiveness of DBT skills training appears to be robust despite variations in treatment length and skills content, which suggests that such training in multiple forms is likely to be useful for different clinical populations.

Acknowledgment—We would like to acknowledge the work of Drs Marsha Linehan, Linda Dimeff, Erin Miga, and Kelly Koerner in compiling a list of DBT randomized controlled trials at Behavioral Tech, LLC.

Visit for News Letters and on line support http://www.mentalhealthsupportcommunity.com

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New Hope for Treating Psychosis

Posted on April 8, 2016 by JmaC

By Thomas Insel on October 20, 2015

 

As with other chronic health conditions, there is no magic bullet for schizophrenia. At least as important as the search for magic bullets, however, is an increasing focus on early intervention and integrating existing treatments. This year, we’ve had encouraging news about integrated, comprehensive approaches for treating people with first episode psychosis, most recently from a major NIMH initiative, theRecovery After an Initial Schizophrenia Episode, or RAISE project. RAISE looked at coordinated specialty care for first episode psychosis. With coordinated specialty care, the young person experiencing first episode psychosis works with a team of specialists to create a personal treatment plan, combining recovery-oriented psychotherapy, low-dose medication management, family education and support, case management, and work or education support. Coordinated specialty care emphasizes shared decision making, including family members, when possible.

RAISE began as two separate studies back in 2008. Each study looked at a different aspect of coordinated specialty care. One study, the RAISE Implementation and Evaluation Study, focused on the best way for clinics to start using the treatment program. The other project, the RAISE Early Treatment Program (RAISE-ETP), studied whether or not the treatment worked better than care typically available in community settings. John M. Kane, M.D., of the North Shore – Long Island Jewish Health System and the Zucker Hillside Hospital, led RAISE-ETP and, today, his team released the primary outcomes from this large clinical trial.1

The RAISE-ETP research team spent five years testing their coordinated specialty care model, called NAVIGATE, at 34 real-world clinics across the country. They compared their treatment program to typical treatment and found that 223 clients who received the NAVIGATE coordinated specialty care program stayed in treatment longer; experienced greater improvement in their symptoms, interpersonal relationships, and quality of life; and were more involved in work or school compared with 181 clients at the typical-care sites. NAVIGATE clients who had a shorter duration of untreated psychosis (the time between the beginning of psychotic symptoms and the beginning of treatment) when they started the study showed greater improvements than those with longer duration of untreated psychosis.

Two other research teams have reported findings in recent months from trials of coordinated care for first episode psychosis. A team at Yale University collaborated with a center run by Connecticut’s mental health agency to test whether a comprehensive first episode psychosis service in the context of a public sector clinic could improve outcomes. After a year, those who received comprehensive care had fewer hospitalizations than those in standard care, were more likely to remain employed, and did better on overall measures of functioning.2 A Danish team also reported that, in a trial of specialized, intensive treatment, patients receiving the intervention for two years had reduced psychotic and negative symptoms, were more satisfied and adherent with treatment, and were hospitalized less than patients receiving standard care.3 As a result of this study, the treatment has been implemented throughout Denmark.

The information coming from these trials shows that coordinated specialty care is an incremental but positive step in treating first episode psychosis. Coordinated specialty care—and ongoing testing of these approaches, with continuous incorporation of findings into practice—brings us closer to being able to intervene in a way that will enable young people with psychosis to avoid the long-term disability and vulnerability that too many experience. It is encouraging to note that more and more states—32 to date—are adopting coordinated specialty care programs to treat first episode psychosis. Their efforts have been supported by additional funding coming from the Community Mental Health Services Block Grant  program administered by theSubstance Abuse and Mental Health Services Administration . Based on the RAISE results, NIMH is launching the Early Psychosis Intervention Network (EPINET), aimed at creating a network of clinical sites offering evidence-based specialty care to persons experiencing signs of first episode psychosis. Using data sharing agreements, EPINET centers will gather participant-level data which can then drive improvements in clinical practice, a “learning health-care system.”

It should perhaps be no surprise that, given the complexity and variability of schizophrenia, outcomes will be better with treatment that is individualized, multi-faceted, and attuned to the preferences of each patient. While we have a long way to go, these recent reports suggest we’re headed in the right direction

References

1 Kane, et al. Comprehensive Versus Usual Community Care for First Episode Psychosis: Two-Year Outcomes From the NIMH RAISE Early Treatment Program.  American Journal of Psychiatry (in press). doi: 10.1176/appi.ajp.2015.15050632. Epub 2015 Oct 20.

2 Srihari VH et al. First-Episode Services for Psychotic Disorders in the U.S. Public Sector: A Pragmatic Randomized Controlled Trial. Psychiatr Serv. 2015 Jul;66(7):705-12. doi: 10.1176/appi.ps.201400236. Epub 2015 Feb 2.

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Let’S get our Heads around Mental Health

Posted on April 8, 2016 by JmaC

Let’s Get Our Heads Around Mental Health

Posted by Keith Jackson March 11, 2016

©iSockphoto/wildpixel

Mental health and behavioral disorders make people feel uncomfortable. I’m not talking about people who have such conditions, I mean the people who don’t. If you don’t have any personal experience of it, it can be – excuse the wording – difficult to “get your head around it.”

If you see a friend or work colleague with a cast on his or her wrist, or hobbling along on crutches, you can immediately sympathize and empathize. You can process the obvious visual clue, and it’s likely you’ve suffered a similar injury and can “feel their pain.”

The clues that someone has a mental health issue can be far more difficult to identify.

Also, chances are, someone with such a condition is doing his best to hide it. But that position is understandable, while a stigma is attached to mental health. And it can be tricky to know what to say if someone does confide in you, or if you find out some other way.

Social awkwardness is one thing, but the real shame is that people can be extremely reluctant to reveal their condition because of the potential detrimental impact on their careers and on workplace relationships. They can be fighting on two fronts – managing the condition itself, and trying present a “normal” façade to the rest of the world.

I like to think that, as individuals, we can overcome initial awkwardness and confusion at learning a friend or colleague has a mental health or behavioral condition, and we will be supportive and do our best to understand and make certain allowances for her. But can organizations do more to help those with disorders or mental health disabilities to succeed and thrive at work?

Managers have to balance their responsibilities to their team members and to their organizations. So, while they may recognize the skills and strengths of someone with a mental health condition, and create an environment that is supportive and inclusive, they must also establish boundaries regarding what behaviors are unacceptable in the workplace.

We have examined this issue in our articles on managing people with PTSDand people on the autistic spectrum. And this week, we explore how tomanage a person with ADHD.

What are your experiences of mental health issues in the workplace? If you have managed someone with a condition, what strategies did you use? And if you have a mental health condition that you felt able to discuss with your manager, colleagues or organization, what reaction did you get? And did you get the support and help you needed? We’d love to hear your views. Let us know in the comments section, below.

 

Mind tools

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Resource’S #2

Posted on April 5, 2016 by JmaC

“CLICKABLE General Medical Information”

Medscape

Searchable, online index to hundreds of medical journals. Many articles are available in full, others as abstracts only.

PubMed

Free interface for searching the MEDLINE medical database, which can help you find out about studies, medications, and more.

“Medications”

There are a number of books available that list side effects, cautions, and more regarding medications. The biggest and best is the Physicians Desk Reference (PDR), but its price is well out of the average parent’s league. You may be able to find a used but recent copy at a good price.

If your child is allergic to food dyes, or to corn, wheat, and other materials used as fillers in pills, you should consult directly with the manufacturer of any medications he takes.

The British National Formulary (BNF). British Medical Association and the Royal Pharmaceutical Society of Great Britain, 1998. The standard reference for prescribing and dispensing drugs in the UK, updated twice yearly.

Preston, John D., John H. O’Neal, and Mary C. Talaga. Consumer’s Guide to Psychiatric Drugs. Oakland, California: New Harbinger Publications, 1998.

Silverman, Harold M., editor. The Pill Book, 8th ed. New York: Bantam Books, 1998. A basic paperback guide to the most commonly used medications in the US.

Sullivan, Donald. The American Pharmaceutical Association’s Guide to Prescription Drugs. New York: Signet, 1998.

Wilens, Timothy E., MD. Straight Talk About Psychiatric Medications for Kids. New York: Guilford Press, 1998.

Canadian Drug Product Database

The DPD contains product specific information on drugs approved for use in Canada. The database is managed by the Therapeutic Products Programme and includes human, veterinary and disinfectant products.

Dr. Bob’s Psychopharmacology Tips

Excellent information on psychiatric drugs, including things like the MAOI dietary restrictions and common SSRI interactions.

Federal Drug Administration (FDA)

Official US information on new drugs and generic versions of old drugs, FDA warnings and recalls, etc.

The Internet Drug List

MedEc Interactive/PDR.net

This medical info site includes a link to a Web-accessible version of the PDR.

Pharmaceutical Information Network

PharmWeb

The Royal Pharmaceutical Society’s Technical Information Center

There is a nominal fee for use of the RPS database, but one might be able to have it waived.

RXmed

“Alternative Medicine Resources”

Balch, James F., MD, and Phyllis A. Balch, CNC. Prescription for Nutritional Healing. Garden City Park, New York: Avery Publishing, 1997.

Baumel, Syd. Dealing with Depression Naturally. New Canaan, Connecticut: Keats Publishing, 1995.

Elkins, Rita. Depression and Natural Medicine. Pleasant Grove, Utah: Woodland Publishing, 1995.

Murray, Michael T., ND. Natural Alternatives to Prozac. New York: William Morrow and Company, 1996.

Norden, Michael J., MD. Beyond Prozac. New York: HarperCollins, 1995.

Stoll, Andrew L., MD. Omega-3 Fatty Acid User Guide. 1998. Available from: Psychopharmacology Research Laboratory, McLean Hospital, 115 Mill Street, Belmont, MA 02478.

“Supplement Suppliers”

The Vitamin Connection 72 Main Street Burlington, VT 05401 Phone: (802) 846-2026 or (800) 760-3020 FREE

Fax: (802) 846-2027

Martek Biosciences 6480 Dobbin Road Columbia, MD 21045 Phone: (410) 740-0081 or (800) 662-6339 FREE Fax: (410) 740-2985 Email:glampf@martekbio.com

Sagami Chemical Research Center Nishi-Ohnuma 4-4-1, Sagamihara Kanagawa 229-0012, Japan Phone: (011) 81-427-42-4791 Fax: (011) 81-427-49-763 Contact: Dr. Kazunaga Yazawa

Source for omega-3 fish oils.

Omega Protein

PO Box 1799 Hammond, LA 70404-1799 Phone: (504) 345-6234 Fax: (504) 345-5744 Email: kshort@i-55.com Contact: Kelsey Short

Source for omega-3 fish oils.

“Medical Facilities”

Sometimes a child’s symptoms are so challenging that your local psychiatrist may want to seek the help of experts. These facilities are among the world’s best-known centers for treating bipolar disorders.

“United States”

KidsPeace: The National Hospital for Kids in Crisis 5300 KidsPeace Drive Orefield, PA 18069-9101 Phone: (800) 334-4KID Email: admissions@kidspeace.org

Mood Disorders Clinic Children’s Hospital 300 Longwood Avenue Boston, MA 02115 Phone: (617) 355-6000

National Institutes of Mental Health (NIMH) Biological Psychiatry Branch Building 10, Room 3N212

9000 Rockville Pike Bethesda, MD 20892 Phone: (301) 496-6827 or (800) 4ll-l222 (Recruitment and Referral) Email: prcc@cc.nih.gov

Stanford Bipolar Disorders Clinic 401 Quarry Road Stanford, CA 94305-5723

Phone: (650) 498-4689 Fax: (65) 723-2507 Email: bipolar.clinic@forsythe.stanford.edu

The Stanley Clinical Research Center Case Western Reserve University/University Hospitals of Cleveland Department of Psychiatry 11100 Euclid Avenue

Cleveland, OH 44106 Phone: (216) 844-3880 Fax: (216) 844-1703

The Stanley Center for the Innovative Treatment of Bipolar Disorders 3811 O’Hara Street, Suite 279 Pittsburgh, PA 15213 Phone: (412) 624-2476 or (800) 424-7657 FREE Fax: (412) 624-0493

Stanley Foundation Bipolar Network 5430 Grosvenor Lane, Suite 200 Bethesda, MD 20814 Phone: (800) 518-7326 FREE Fax: (301) 571-0768 Email:info@bipolarnetwork.org

This is a multi-center research effort, including the Stanley Foundation Center at Johns Hopkins University, NIMH, and several other institutions.

University of Texas Southwestern Bipolar and Research Program 8267 Elmbrook Drive, Suite 250 Dallas, TX 75247 Phone: (214) 689-3765 Fax: (214) 689-3751 Email: mwestl@mednet.swmed.edu Contact: Mary Ann Westlake

“Canada”

Canadian Network for Mood and Anxiety Treatments (CANMAT)

This is a consortium of university medical schools and other research organizations concentrating on depression, bipolar disorders, and anxiety disorders. Their web site can link you with a CANMAT center near you, and also provides information about diagnosis and treatment options.

University of British Columbia Mood Disorders Clinic Department of Psychiatry Vancouver Hospital & Health Sciences Centre, UBC Site 2211 Wesbrook Mall

Vancouver, BC V6T 2A1 Canada Phone: (604) 822-9745 Fax: (604) 822-7922

“Public Mental Health Agencies”

“United States”

Alabama

Department of Mental Health and Mental Retardation

RSA Union 100 N. Union Street Montgomery, AL 36130-1410 Phone: (334) 242-3417 Fax: (334) 242-0684

Alaska

Division of Mental Health and Developmental Disabilities 350 Main Street, Room 217

PO Box 110620 Juneau, AK 99811-0620 Phone: (907) 465-3370 or (800) 465-4828 FREE Fax: (907) 465-2668 TDD: (907) 465-2225Email: Director@health.state.ak.us

Arizona

Department of Health Services Behavioral Health 2122 E. Highland Phoenix, AZ 85016 Phone: (602) 381-8999 Fax: (602) 553-9140 Email:adelatr@hs.state.az.us

Arkansas

Department of Human Services Division of Mental Health 4313 West Markham Little Rock, AR 72205 Phone: (501) 686-9164 TTD: (501) 686-9176 Fax: (501) 686-9182

Colorado

Mental Health Services 3824 W. Princeton Circle Denver, CO 80236 Phone: (303) 866-7400 Fax: (303) 866-7428

District of Columbia

DC Commission on Mental Health Services Child Youth Services Administration 2700 Martin Luther King Avenue SE St. Elizabeth’s Hospital, L Bldg. Washington, DC 20032 Phone: (202) 373-7225

Florida

Children’s Medical Services (CMS)

Department of Health and Rehabilitative Services 1311 Winewood Boulevard Building 5, Room 215 Tallahassee, FL 32301 Phone: (904) 488-4257

Georgia

Department of Human Resources 2 Peachtree Street NW, Suite 22-205

Atlanta, GA 30303 Phone: (404) 657-2260 Email: xwiggins@dmh.dhr.state.ga.us

Hawaii

Department of Human Services 1000 Bishop Street, No. 615 Honolulu, HI 96813

Phone: (808) 548-4769

Idaho

Department of Health and Welfare 450 W. State Street Boise, ID 83720-0036 Phone: (208) 334-5500

Illinois

Department of Mental Health and Developmental Disabilities

402 Stratten Office Building Springfield, IL 62706 Phone: (217) 782-7395

Indiana

Division of Mental Health Family and Social Services Administration 402 W. Washington W353 Indianapolis, IN 46204

Phone: (317) 232-7841 TDD: (317) 232-7844 Fax: (317) 233-3472

Iowa

Hoover Building, 5th Floor Des Moines, IN 50310 Phone: (515) 278-2502

Kansas

Child & Adolescent Mental Health Programs 506 N. State Office Building Topeka, KS 66612 Phone: (913) 296-1808

Kentucky

Department of Mental Health and Mental Retardation Services 100 Fair Oaks Lane, 4th Flr.

Frankfort, KY 40621 Phone: (502) 564-7610

Louisiana

Department of Health and Human Resources
PO Box 4049 655 N. 5th Street Baton Rouge, LA 70821
Phone: (504) 342-2548

Maine

Department of Mental Health and Mental Retardation
State House Station 40 Augusta, ME 04333
Phone: (207) 287-4200 or (888) 568-1112 FREE
(Crisis number) TTY: 207-287-2000 Fax: 207-287-4268

Maryland

Department of Health and Mental Hygiene

201 W. Preston Street O’Connor Building, 4th Floor
Baltimore, MD 21201
Phone: (410) 767-6860 TDD: (800) 735-2258 FREE

Massachusetts

Department of Mental Health

25 Staniford Street Boston, MA 02214
Phone: (617) 727-5600 Fax: (617) 727-4350

Minnesota

Children’s Mental Health
c/o Minnesota Department of Human Services
444 Lafayette Road

St. Paul, MN 55155 Phone: (651) 297-5242

Minnesota Children with Special Health Needs
717 Delaware Street SE PO Box 9441
Minneapolis, MN 55440-9441
Phone: (612) 676-5150 or (800) 728-5420 FREE
Fax: (612) 676-5442

Email: mcshn@kids.health.state.mn.us

Mississippi

Department of Mental Health
1101 Robert E. Lee Building
239 N. Lamar Street Jackson, MS 39201
Phone: (601) 359-1288

Fax: (601) 359-6295

Missouri

Children’s Mental Health
c/o Department of Mental Health
1706 East Elm Street
PO Box 687 Jefferson City, MO 65102
Phone: (573) 751-3070 or (800) 364-9687 FREE

Email: dmhmail@mail.state.mo.us

Montana

Department of Public Health and Social Services
PO Box 4210 111 Sanders, Room 202 Helena, MT 59604
Phone: (406) 444-2995

Nebraska

Nebraska Health and Human Services Office
of
Community Mental Health
PO Box 95007 Lincoln, NE 68509
Email:” target=”_blank” rel=”nofollow”>www.hhs.state.ne.us”>hhsinfo@www.hhs.state.ne.us

Nevada

Department of Human Resources
State Capitol Complex
505 E. King Street Carson City, NV 98710
Phone: (702) 687-4440

New Hampshire

Division of Mental Health
c/o
Department of Health and Human Services
State Office Park South 105 Pleasant Street Concord, NH 03301
Phone: (603) 271-5065

New Jersey

“Services for Children with Special Health Care Needs”

New Jersey Department of Health
and
Senior Services
PO Box 364 Trenton, NJ 08625
Phone: (609) 984-0755

New Mexico

Human Services Department
1190 S. St. Francis Drive

P.O. Box 2348 Santa Fe, NM 87504
Phone: (505) 827-7750 or
(800) 432-6217 FREE TDD:
(800) 609-4TDD Email: marty.eckert@state.nm.us

New York

New York State Office of Mental Health

44 Holland Avenue Albany, NY 12229
Phone: (518) 474-6540 Fax: (518) 473-3456

North Carolina

Division of Mental Health
Department of Health and Human Services
Albemarle Building

325 N. Salisbury St. Raleigh, NC 27603
Phone: (919) 733-7011 Fax: 919-733-9455

North Dakota

Department of Human Services
State Capitol Building 600 E. Boulevard Avenue, Dept 325

Bismarck, ND 58505
Phone: (701) 328-2310
or
(800) 472-2622 FREE TTY: (800) 366-6888
Fax: (701) 328-2359 Email: sosteh@state.nd.us

Ohio

Department of Mental Health

State Office Tower 30 E. Broad Street,
8th Floor Columbus, OH 43266-0414
Phone: (614) 466-1483
Email: helpdesk@mhmail.mh.state.oh.us

Oklahoma

Department of Mental Health and Substance Abuse

1200 NE 13th Street
PO Box 53277 Oklahoma City, OK 73152-3277
Phone: (405) 522-3908 or
(800) 522-9054 FREE (Hotline)

Oregon

Office of Mental Health Services
Department of Human Resources 2575 Bittern Street NE

Salem, OR 97309-0740
Phone: (503) 975-9700 Fax: (503) 373-7327

Pennsylvania

Special Kids Network Department of Health PO Box 90 Harrisburg, PA 17108

Phone: (800) 986-4550 FREE

Rhode Island

Department of Mental Health, Retardation, and Hospitals
Aime J. Forand Building
600 New London Avenue Cranston, RI 02920
Phone: (401) 464-3291

South Carolina

Department of Mental Health
2414 Bull Street, Room 304
Columbia, SC 29202
Phone: (803) 898-8581 Email: scdmh@yahoo.com

South Dakota

Division of Developmental Disabilities

Department of Human Services Hillsview
Plaza, E. Hwy 34 c/o 500 East Capitol Pierre,
SD 57501-5070
Phone: (605) 733-3438
Email:infodd@dhs.state.sd.us

Tennessee

Department of Mental Health and Mental Retardation
3rd Floor, Cordell Hull Building 425
Fifth Avenue North Nashville, TN 37243
Phone: (615) 532-6500

Texas

Department of Mental Health and Mental Retardation
909 West 45th Street

PO Box 12668 Austin, TX 78711
Phone: (512) 454-3761

Utah

State Division of Mental Health
Department of Human Services
120 N. 200 W., Room 415 Salt Lake City, UT 84145

Phone: (801) 538-4270

Vermont

Department of Developmental and Mental Health Services
103 S. Main Street Weeks Building
Waterbury, VT 05671-1601
Phone: (802) 241-2609

Virginia

Department of Mental Health, Mental Retardation, and Substance Abuse Services
PO Box 1797 Richmond, VA 23218
Phone: (804) 786-3921 or (800) 451-5544 FREE TDD:
(804) 371-8977 Fax (804) 371-6638

Washington

Mental Health Division

Health and Rehabilitative Services Administration
PO Box 1788, OB-42C Olympia, WA 98504
Phone: (800) 446-0259 FREE

West Virginia

Department of Health and Human Resources
Capitol Complex Bldg. 3 Room 206

Charleston, WV 25305 Phone: (304) 348-0627

Wisconsin

Bureau of Community Mental Health
Department of Health and Family Services
1 W. Wilson Street, Room 433 PO Box 7851

Madison, WI 53707
Phone: (608) 261-6746 Fax: (608) 261-6748

Canada

British Columbia

British Columbia Ministry of Health
Parliament Buildings Victoria, BC V8V 1X4

Phone: (250) 952-1742 or (800) 465-4911 FREE

Manitoba

Manitoba Health
Legislative Building Winnipeg, MB R3C 0V8
Phone: (204) 786-7111 or (877) 218-0102 FREE

New Brunswick

New Brunswick Health and Community Services
PO Box 5100 Fredericton, NB E3B 5G8
Phone: (506) 453-2536 Fax: (506) 444-4697

Newfoundland and Labrador

Newfoundland Department of Health and Community Services
Division of Family and Rehabilitative Services

Confederation Building,
West Block PO Box 8700 St. John’s, NF A1B 4J6
Phone: (709) 729-5153 Fax: (709) 729-0583

Nova Scotia

Nova Scotia Department of Health
PO Box 488

Halifax:, NS B3J 2R8
Phone: (902) 424-5886 or (800) 565-3611 FREE

Prince Edward Island

Prince Edward Island Health and Social Services
Second Floor, Jones Building 11 Kent Street PO Box 2000

Charlottetown, PE C1A 7N8
Phone: (902) 368-4900 Fax: (902) 368-4969

Quebec

Quebec Ministére de la Santé et Services Sociaux
1075 Chemin Sainte-Foy, R.C. Québec, QC G1S 2M1

Phone: (418) 643-3380 or (800) 707-3380 FREE
Fax: (418) 644-4574

Saskatchewan

Saskatchewan Health
T.C. Douglas Building
3475 Albert Street Regina, SK S4S 6X6
Phone: (306) 787-3475

Fax: (306) 787-3761

“United Kingdom”

People in England, Scotland, Wales, and Northern Ireland
will generally need to be referred to a specialist
at a clinic or hospital by their general practitioner.

The National Health Service Confederation

This site lists all local NHS authorities and boards,
as well as specific sites for healthcare (including mental health services).

Ireland

Eastern Health Board

Dr. Steevens Hospital Dublin 8
Phone: 1800 520 520

Midland Health Board, Arden Road
Tullamore, County Offaly (0506) 21868

North Eastern Health Board

Kells, County Meath (046) 40341

North Western Health Board
Manorhamilton, County Leitrim
Phone: (072) 55123 Fax: (072) 20431

Southern Health Board

Wilton Road County Cork
Phone: (021) 545011 Fax: (021) 545748

Western Health Board
Merlin Park Regional Hospital Galway
Phone: (091) 757631

Fax: (091) 770203

Australia

Australian Capitol Territory
Commonwealth Department of Health and Family Services
Child Health and Development Service
Weingarth Street at Blackwood Terrace Holder, ACT 2611
Phone: (02) 6205-1277

New South Wales

Commonwealth Department of Health and Family Services
1 Oxford Street Darlinghurst, NSW
Phone: (02) 9263-3555 or (800) 048-998

Northern Territory

Northern Territory Health Services
PO Box 40596

Casuarina, NT 0811
Phone: (08) 8999-2400 Fax: (08) 8999-2700

Queensland

Commonwealth Department of Health and Family Services
340 Adelaide Brisbane, Queensland
Phone: (07) 3360-2555

South Australia

Commonwealth Department of Health and Family Services
55 Currie Street Adelaide, SA 5000
Phone: (08) 8237-6111 Fax: (08) 8237-8000

Tasmania

Commonwealth Department of Health and Community Services
Child and Family Services

4 Farley Street Glenorchy, Tasmania
Phone: (03) 6233-2921

Victoria

“Department of Health and Family Services”

Disability Programs Casselden Place
2 Lonsdale Street GPO Box 9848

Melbourne, Victoria 3001 (03) 9285-8888

Western Australia

Department of Health and Family Services
Central Park, 12th Floor 152 St. George Terrace Perth, WA 6000
Phone: (08) 9346-5111 or (800) 198-008

Fax: (08) 9346-5222

New Zealand

New Zealand Ministry of Health
133 Molesworth Street PO Box 5013 Wellington, NZ
Phone: (04) 496-2000 Fax: (04) 496-2340

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Resource’S # 1

Posted on April 5, 2016 by JmaC

“United States”

Depression and Related Affective Disorders Association (DRADA) Meyer 3-181, 600 North Wolfe Street Baltimore, MD 21287-7381 Phone: (410) 955-4647

The Child and Adolescent Bipolar Foundation (CABF) ll87 Wilmette Avenue, #33l Wilmette, IL 6009l Phone: (847) 256-8525 Fax: (847) 920-9310 Email:cabf@bpkids.org

A parent-led group providing education, support, and advocacy for children, adolescents, families and professionals.

Federation of Families for Children’s Mental Health 1021 Prince Street Alexandria, VA 22314-2971 Phone: (703) 684-7710 Fax: (703) 836-1040 Email:ffcmh@ffcmh.org

A group for families, especially low-income families, who are caring for a child with a mental illness.

National Alliance for the Mentally Ill (NAMI) Colonial Place Three 2107 Wilson Blvd. – Suite 300 Arlington, VA 22201-3042 Phone: (703) 524-7600 or (800) 950-NAMI (Helpline) Fax: (703) 524-9094 TDD: (703) 516-7227

NAMI is the largest organization for mentally ill people and their families in the US. It has state and local chapters around the country, sponsors legislation, advocates for mentally ill people, and provides excellent information via its web site and publications.

National Depressive and Manic-Depressive Association 730 N. Franklin Street, Suite 501 Chicago, IL 60610-3526 Phone: (312) 642-0049 or (800) 826-3632 FREE Fax: (312) 642-7243

This support and advocacy group specifically for people with depression or bipolar depression has chapters throughout the US and an informative web site.

“Canada”

Canadian Mental Health Association Simon Fraser Branch #3-260 Twelfth Street New Westminster, BC Canada V3M 4H2 Phone: (604) 524-2821 Fax: (604) 524-2870 Email: cmha@radiant.net

Integrated Network of Disability Information and Education Email: info@indie.ca

Mood Disorders Association of British Columbia 2730 Commercial Drive, #201 Vancouver, BC

Canada V5N 5PN Phone: (604) 873-0103 Fax: (604) 873-3095 Email: mda@lynx.bc.ca

“United Kingdom”

Glasgow Association for Mental Health Melrose House, First Floor

15/23 Cadogan Street Glasgow, G2 6QQ Phone: (0141) 204 2270 Fax: (0141) 204 2770 Email: GAMH@colloquium.co.uk

Manic Depression Fellowship 8-10 High Street

Kingston-upon-Thames Surrey KT1 1EY UK Phone: (0181) 974 6550 Email: mdfgl@mdfglmhmip.u-net.com

This organization has regional offices in Wales, Greater London, and Manchester, as well as 125 local groups throughout the UK. It provides support, advice, and information for people with manic depression, their families, friends, and carers.

Mental Health Foundation 20/21 Cornwall Terrace

London NW1 4QL Phone: 0207 535 7400 Fax: 0207 535 7474 Email: mhf@mentalhealth.org.uk

National Alliance of the Relatives of the Mentally Ill (NARMI) Tydehams Oaks Tydehams, Newbury

Berks RG14 6JT Phone: (01635) 551923

National Disability Council Caxton House, Level 4A Tothill Street London SW1H 9NA Phone: 0207 273 5636 Fax: 0207 273 5929

Minicom: 0207 273 5645 Email: chairman.ndc@dfee.gov.uk

Northern Ireland Association for Mental Health Beacon House 80 University Street Belfast BT7 1HE Phone: 028 9032 8474

Fax: 028 9023 4940

SANE 1st Floor, Cityside House 40 Adler Street London E1 1EE Phone: (0171) 724 6520 (office) National Helpline: 0345 67 8000 (daily 2:00 pm to midnight)

SANE is a mental health charity which campaigns to improve attitudes and services for sufferers and their families.

UK Advocacy Network Volserve House 14-18 West Bar Green Sheffield S1 2DA Phone: (0114) 272 8171

Young Minds 102-108 Clerkenwell Road, 2nd Floor London EC1M 5SA

Phone: (0171) 336 8445 (office) or (0800) 018 2138 FREE (Parents Hotline) Fax: (0171) 336 8446 Email: enquiries@youngminds.org.uk

“Ireland”

AWARE 147 Phipsborough Road Dublin 7 Ireland

Phone: (01) 830 8449 or (0) 679 1711 (Helpline)

AWARE offers help by phone, sponsors support groups in 38 locations around Ireland, provides information and literature, does public advocacy, and supports research.

Mental Health Association of Ireland Mensana House, 6 Adelaide Street Dun Laoghaire, County Dublin Ireland Phone: (01) 284 1166 Fax: (01) 284 1736 Email:info@mensana.org

“Australia”

Action Resource Network Inc. 266 Johnston Street Abbotsford, Victoria 3067 Phone: (03) 9416-3488 or (800) 808-126 Fax: (03) 9416-3484 TTY: (03) 9416-3491

Association of Relatives and Friends of the Mentally Ill (ARAFMI)

c/o Mental Health Resource Centre 1 Richmond Road Keswick, SA 5035 Phone: (08) 8221 5166 Fax: (08) 8221 5159

ARAFMI has chapters in most Australian states.

Disability Action Inc.

62 Henley Beach Road Mile End, SA 5031 Phone: (08) 8352 8599 or 1(800) 805 495 Fax: (08) 8354 0049 TTY: (08) 8352 8022 Email:email@disabilityaction.in-sa.com.au Contact: Brad or Jen

Mood Disorders Association (SA) Inc./Self-Help (MDP) Inc.

MHRC Building, 1 Richmond Road Keswick, SA 5035 Phone: (08) 8221-5170 Fax: (08) 8221-5159

MDA offers education and support services to those who may be suffering from depression and manic depression.

SANE Australia PO Box 226 South Melbourne, Victoria 3065

Phone: (61) 3 9682 5933 Fax: (61) 3 9682 5944 Email: sane@sane.org

“New Zealand”

Richmond Fellowship 249 Madras Street, Level 3 Christchurch, NZ

Phone: (64) 3 365-3211 Fax: (64) 3 365-3905 Email: national@richmond.org.nz

“Books and Publications”

Berger, Diane, et al. We Heard the Angels of Madness: A Family Guide to Coping with Manic Depression. New York: Quill, 1992.

Bipolar Disorders Letter

This is an online newsletter, mostly for professionals but of interest to parents as well. It summarizes recent studies on treatments. You’ll need the free program Acrobat Reader to look at it.

Bipolar Network News (newsletter). Stanley Foundation Bipolar Network, Bethesda, Maryland.

Fieve, Ronald R. Moodswing: Dr. Fieve on Depression (revised edition). New York: Bantam Books, 1997.

Guiness, David. Inside Out: A Guide to Self-Management of Manic Depression (booklet). The Manic Depression Fellowship (UK), 1998.

Halebsky, Mark. Surviving the Crisis of Depression and Bipolar Illness: Layperson’s Guide to Coping with Mental Illness Beyond the Time of Crisis and Outside the Hospital. Arvada, Colorado: Personal and Professional Growth Organization, 1997.

Jamison, Kay Redfield. An Unquiet Mind. New York: Random House, 1997. Dr. Jamison is one of the most prominent experts on bipolar disorders–and is herself a manic-depressive. This is her fascinating (and for worried parents, heartening) memoir.

Jamison, Kay Redfield. Touched with Fire: Manic-Depressive Illness and the Artistic Temperament. New York: Free Press, 1996.

Walsh, Mitzi. Bipolar Disorders: A Guide to Helping Children and Adolescents. Sebastopol: O’Reilly, 1999. A comprehensive book for parents that covers diagnosis, family life, medications, talk therapies and other interventions, insurance, and school. The book from which these resources are taken.

“Web sites”

Bipolar Disorders Center

For parents and caregivers of bipolar children and teens. Substantial excerpts from the the book Bipolar Disorders by Mitzi Walsh and other news and content.

BiPolar Children and Teens

This parent-run page features lots of supportive information and personal stories, including an incomplete list of support groups in the US and Canada for parents of children with mental illness, and links to an AOL chat room and several mailing lists.

BipolarKids list

This fabulous list for parents of bipolar children and teens is moderated by parent volunteers, and sponsored through the generosity of Active-Websites, owned by Steve Worden. It’s an excellent source of support and reliable information. To subscribe, see the requirements at their web site.

Bipolar (Mining Co.)

A collection of articles, links, and a Web chat group about bipolar disorders.

BPSO list Email: majordomo@ipl.co.uk

For parents, spouses, siblings, and friends of people with bipolar disorder. To subscribe, send email, and in the body of the message, write: subscribe bpso.

FyrenIyce

Information about bipolar disorders, and links to support and advocacy groups in Australia and elsewhere. There’s also a FyrenIyce email list.

Harbor of Refuge

Volunteer run organization that offers peer to peer support for people with bipolar disorder and those that care about them.

www.mgh.harvard.edu/” target=”_blank” rel=”nofollow”>Massachusetts General Hospital Neurology Forums

This site features discussion groups (live and bulletin board style) on almost every known neurological disorder, including bipolar disorders.

Moodswing.org

Home of the Bipolar FAQ (frequently asked questions list).

Pendulum Resources

You can find up-to-date information on bipolar disorders here, with a strong mental health consumer orientation.

WalkersWeb

WalkersWeb is the home of several mailing lists geared toward people with bipolar disorders or depression. It also has excellent links to mental health sites, its own informational files, and online chat groups.

“Related Conditions and Symptoms”

If your child has multiple diagnoses or simply shares symptoms with another condition, these books and online resources may help.

Hallowell, Edward. When You Worry About the Child You Love: Emotional and Learning Problems in Children. New York: Simon & Schuster, 1996. This book provides a good introduction to the whole spectrum of psychiatric, emotional, developmental, and learning disorders in young children. It’s very readable.

ADD/ADHD

Hallowell, Edward. Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood. Reading, Massachusetts: Addison-Wesley, 1994. The classic book on ADD/ADHD.

Hallowell, Edward, and John Ratey. Answers to Distraction. New York: Bantam Books, 1996. A companion to Dr. Hallowell’s Driven to Distraction, this book provides behavior management and learning strategies to help the ADD/ADHD child.

ODD/Conduct disorders

Oppositional Defiant Disorder: What is it?

A Place for Us

This web site includes a parent message board, information, and links about conduct disorders, ODD, and related problems.

Eating disorders

Eating Disorders Association Resource Centre Phone: (07) 3352 6900 Email: eda.inc@uq.net.au

Most services are limited to Australia, but does contain a comprehensive list of related links, books and FAQ’s.

Eating Disorders Shared Awareness (EDSA)

This site includes links to US and Canadian support and informational sites on anorexia and bulimia.

Eating Disorders Association Wenson House, 1st Floor 103 Prince of Wales Road Norwich NR1 1DW UK Phone: (0160) 362-1414

Seasonal affective disorder

Rosenthal, Norman E., MD. Winter Blues. New York: The Guilford Press, 1993.

National Organization for Seasonal Affective Disorder (NOSAD) PO Box 40190 Washington, DC 20016 Phone: (301) 762-0768

SAD Homepage

Environmental Health and Light Research Institute 16057 Tampa Palms Boulevard, Suite 227 Tampa, FL 33647 Phone: (800) 544-4878 FREE

Light system vendors:

Apollo Light Systems Inc. 352 West 1060 South

Orem, UT 84058 Phone: (801) 226-2370

Hughes Lighting Technologies 34 Yacht Club Drive Lake Hopatcong, NJ 07849 Phone: (973) 663-1214 or (800) 544-4825 FREE Fax: (973) 663-3496

The SunBox Company

19217 Orbit Drive Gaithersburg, MD 20870 Phone: (301) 869-5980 or (800) 548-3968 FREE Email: sunbox@aol.com

Self-injurious behavior (SIB)

Strong, Marilee. A Bright Red Scream: Self-Mutilation and the Language of Pain. New York: Viking Press, 1998.

Levenkron, Steven. Cutting: Understanding and Overcoming Self-Mutilation. New York: W. W. Norton & Company, 1998.

Alderman, Tracy. The Scarred Soul: Understanding and Ending Self-Inflicted Violence. Oakland, California: New Harbinger Publications, 1997.

Bodies-Under-Siege mailing list Email: majordomo@majordomo.pobox.com

Bodies-Under-Siege is an online support group for people with self-injurious behavior. May not be appropriate for all teens with SIB, but some may find this therapeutic. To subscribe, send email, and in the body of the message, write: subscribe bus.

Secret Shame

Secret Shame is a web site about self-injury, offering information and support to people with SIB and their families.

Suicide prevention

The National Alliance for the Mentally Ill Phone: (703) 524-7600

NAMI is the largest support group for people with mental illness in the US. Its national information line or web site can help you find local resources right away.

National Suicide Prevention Hotline (US) Phone: (800) 999-9999 FREE

Call this number to get information about the closest suicide prevention hotline.

Suicide Awareness/Voices of Education (SA/VE)

Suicide Information and Education Centre (SEIC)

SEIC maintains a list of suicide prevention hotlines and services in the US and Canada.

Befrienders International Online

The Befrienders maintain a list of crisis and suicide counseling centers throughout the world.

Substance abuse

Adolescent Substance Abuse and Recovery Resources

Includes links to AA, NA, and many other groups that can help young people stop using drugs and alcohol.

Canadian Centre on Substance Abuse 75 Albert Street, Suite 300 Ottawa, ON K1P 5E7 Canada Phone: (613) 235-4048 Fax: (613) 235-8101

Drugline Ltd. 9A Brockley Cross

Brockley, London SE4 2AB UK Phone: (0181) 692-4975

“Special-Needs Parenting”

Bending the Rules: A Guide for Parents of Troubled Children. Michael McDonald Productions, 1996. Made by the Southern California chapter of the Tourette Syndrome Association, this is an excellent video on handling problem behaviors that are driven by brain dysfunction. It comes highly recommended by parents. Call (818) 881-3211 to order.

Bruun, Ruth Dowling, MD, et al. Problem Behaviors and Tourette’s Syndrome (pamphlet). Bayside, New York: Tourette Syndrome Association, 1993. Contact information: 42-40 Bell Boulevard, Bayside, NY 11361-2820, (718) 224-2999.

Budman, Cathy, MD, and Ruth Dowling Bruun, MD. Tourette Syndrome and Repeated Anger Generated Episodes (RAGE) (pamphlet). Bayside, New York: Tourette Syndrome Association, 1998.

Greene, Ross. The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, “Chronically Inflexible” Children. New York: HarperCollins, 1998. The title says it all: This may be the best book ever on raising a child with bipolar disorder, or even just a “difficult” temperament. Full of parent-tested strategies for defusing behavior problems.

Greenspan, Stanley I., with Jacqueline Salmon. The Challenging Child. Reading, Massachusetts: Addison-Wesley, 1995. Dr. Greenspan explains why some kids have a “challenging” temperament, and offers excellent ideas for turning down the volume of outbursts, anxiety, and other behavior problems.

Greenspan, Stanley I., with Jacqueline Salmon. Playground Politics: Understanding the Emotional Life of Your School-Age Child. Reading, Massachusetts: Addison-Wesley, 1993. Help for parents with children who don’t fit in.

Greenspan, Stanley I., and Serena Wieder, with Robin Simons. The Child with Special Needs. Reading, Massachusetts: Addison-Wesley, 1998. This book concentrates on working with developmentally or emotionally challenged children from infancy through school age. Highly recommended, especially if your child has an additional diagnosis of PDD/autism, ADHD, etc.

Kurcinka, Mary Sheedy. Raising Your Spirited Child. New York: HarperPerennial, 1991. Covers handling sensory defensiveness and other contributors to “spirited” behavior.

Marsh, Diane T., Rex M. Dickens, and E. Fuller Torrey. How to Cope with Mental Illness in Your Family: A Self-Care Guide for Siblings, Offspring, and Parents. New York: Putnam Publishing Group, 1998.

Meyer, Donald, editor. Uncommon Fathers: Reflections on Raising a Child with a Disability. Rockville, Maryland: Woodbine House, 1995.

Naseef, Robert A. Special Children, Challenged Parents: The Struggles and Rewards of Raising a Child with a Disability. New York: Birch Lane Press, 1997.

Phelan, Thomas W. 1-2-3 Magic: Effective Discipline for Children 2-12. Glen Ellyn, Illinois: Child Management Inc., 1996. Phelan has devised a workable system for managing behavior without getting physical, especially for strong-willed kids. Many parents swear by it. Also available on tape.

Wollis, Rebecca, and Agnes Hatfield. When Someone You Love Has a Mental Illness: A Handbook for Family, Friends, and Caregivers. Los Angeles: J. P. Tarcher, 1992.

“Sibling Issues”

Meyer, Donald, and Patricia Vadasy. Living with a Brother or Sister with Special Needs. Seattle: University of Washington Press, 1996.

Meyer, Donald, editor. Views from Our Shoes: Growing up with a Brother or Sister with Special Needs. Rockville, Maryland: Woodbine House, 1997.

Sib Kids Club

A web site for kids who have a sibling with a disability.

SibShops/Sibling Support Project Children’s Hospital and Medical Center PO Box 5371, CL-09 Seattle, WA 98105 Phone: (206) 368-4911 Fax: (206) 368-4816

SibShops are special support groups for children dealing with a sibling’s disability. This site provides information on SibShops and related topics, and can help you find a SibShop program in your area.

“Special Education”

Anderson, Winifred, Stephen Chitwood, and Dierdre Hayden. Negotiating the Special Education Maze: A Guide for Parents and Teachers, 2nd ed. Rockville, Maryland: Woodbine House, 1990. Well-written and very complete. A new edition with information on the changes wrought in IDEA 97 was said to be in production at press time.

Cutler, Barbara Coyne. You, Your Child, and “Special” Education: A Guide to Making the System Work. Baltimore: Paul H. Brookes Publishing, 1993. A guide to fighting the system on your child’s behalf.

Dornbush, Marilyn P., and Sheryl K. Pruitt. Teaching the Tiger: A Handbook for Individuals Involved in the Education of Students With Attention Deficit Disorders, Tourette Syndrome, or Obsessive Compulsive Disorder. Duarte, California: Hope Press, 1995. This is a wonderful book, full of practical suggestions, organizing aids, and ideas for teachers, parents, and students. Very applicable to children with bipolar disorders, with or without ADD/ADHD.

Advocating for the Child

Maintained by the mother of neurologically challenged children, this site is an all-purpose guide to advocating for your child’s educational rights in the US. Information-rich, with great links and lots of inspiration.

The Special Ed Advocate/Wrightslaw

This is the place to find the actual text of special education laws, information on the latest court battles, and answers to your special education questions.

Special Education and Disabilities Resources

US information and links on special education law, assistive technology, and related topics.

“Healthcare and Insurance”

Beckett, Julie. Health Care Financing: A Guide for Families. To order, contact: the National Maternal and Child Health Resource Center, Law Building, University of Iowa, Iowa City, IA 52242, (319) 335-9073. This overview of the healthcare financing system includes advocacy strategies for families, and information about public health insurance in the US.

How to Get Quality Care for a Child with Special Health Needs: A Guide to Health Services and How to Pay for Them. To order, contact: The Disability Bookshop, PO Box 129, Vancouver, WA 98666-0129, (206) 694-2462 or (800) 637-2256 FREE.

Larson, Georgianna, and Judith Kahn. Special Needs/Special Solutions: How to Get Quality Care for a Child with Special Health Needs. St. Paul: Life Line Press, 1991.

Neville, Kathy. Strategic Insurance Negotiation: An Introduction to Basic Skills for Families and Community Mental Health Workers (pamphlet). To order, contact: CAPP/NPRC Project, Federation for Children with Special Needs, 95 Berkeley Street, Suite 104, Boston, MA 02116. Single copies available at no cost.

Association of Maternal and Child Health Programs (AMCHP) 1220 19th Street, N.W., Suite 801 Washington, DC 20036 Phone: (202) 775-0436 Fax: (202) 775-0061

Email: info@amchp.org

Call AMCHP to locate your state’s Children with Special Health Care Needs Program.

National Association of Insurance Commissioners (NAIC) Hall of States 444 North Capitol Street NW, Suite 701 Washington, DC 20001-1512 Phone: (202) 624-7790

Call NAIC to locate your state insurance commissioner, who can tell you about health insurance regulations in your state regarding bipolar disorders.

Association for the Care of Children’s Health ACCH Publications 19 Mantua Road Mt. Royal, NJ 08061 Phone: (609) 224-1742

This group offers a variety of publications on child healthcare, including guides to prepare a child for the hospital and many items for parents of special-needs children.

Mail order pharmacies

CanadaRx

This is a consortium of Canadian pharmacies set up specifically to provide discounted prescriptions to US customers, although Canadians and others can use the service as well. Mail-order arrangements must be made over the Net, or directly through one of the consortium members (their addresses are available on the web site).

Continental Pharmacy PO Box 94863 Cleveland, OH 44101-4863 Phone: (216) 459-2010 or (800) 677-4323 FREE Fax: (216) 459-2004

Farmacia Rex S.R.L. Cordoba 2401 Esq. Azcuénaga 1120 Buenos Aires, Argentina Phone: (54-011) 4961-0338 Fax: (54-011) 4962-0153

Deeply discounted prices, and they mail anywhere.

GlobalRx 4024 Carrington Lane Efland, NC 27243 Phone: (919) 304-4278 or (800) 526-6447 FREE Fax: (919) 304-4405 Email:info@globalrx.com

Masters Marketing Company, Ltd.

Masters House No. 1 Marlborough Hill Harrow, Middlesex HA1 1TW England Phone: (011) 44-181-424-9400 Fax: (011) 4481 427 1994

Carries a limited selection of European pharmaceuticals, as well as a few American-made drugs, including Prozac.

No Frills Pharmacy

1510 Harlan Drive Bellevue, NB 68005 Phone: (800) 485-7423 FREE Fax: (402) 682-9899 Email: refill@nofrillspharmacy.com

Peoples Pharmacy

This Austin, Texas-based chain provides Net-only mail-order service, and can compound medications as well.

Pharmacy Direct 3 Coal Street Silverwater, NSW 2128 Australia Phone: (02) 9648 8888 or (1300) 656 245 Fax: (02) 9648 8999 or (1300) 656 329 Email:pharmacy@pharmacydirect.com.au

You must have a prescription from an Australian doctor to use this mail-order service.

The Pharmacy Shop (Drugs By Mail) 5007 N. Central Phoenix, AZ 85012 Phone: (602) 274-9956 or (800) 775-6888 FREE Fax: (602) 241-0104 Email:sales@drugsbymail.com

Preferred Prescription Plan 2201 W. Sample Road, Bldg 9, Ste 1-A Pompano Beach, FL 33073 Phone: (954) 969-1230 or (800) 881-6325 FREE Fax: (800) 881-6990 Email:cust-svc@DrugPlace.com

Stadtlanders Pharmacy 600 Penn Center Boulevard Pittsburgh, PA 15235-5810 Phone: (800) 238-7828 FREE Email: enroll@stadtlander.com

Stadtlanders Pharmacy has a stellar reputation in the disability community.

Victoria Apotheke (Victoria Pharmacy) Bahnhofstrasse 71 Postfach CH-8021 Zurich, Switzerland Phone: (01) 211-2432 (Europe) or (011) 411-211-24 32 (US) Fax: (01) 221-2322 (Europe) or (011) 411-221-2322 (US) Email: victoriaapotheke@access.ch

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Clickable ORGANIZATIONS

Posted on April 5, 2016 by JmaC

Bipolar Disorder and other serious brain diseases are an extreme challenge not only for the person afflicted, but for the entire family. It helps a great deal to be able to talk with other people who have, or are, going through the same things that you are – to share tips and local resources in coping, and to work together in getting the best possible treatment in your city or area.
Below are good sources for finding such a support group. Also listed are the National Mental Health Offices that should be able to help with regard to the governmental services for mental health. If there isn’t a support group in your area start one – the national offices of each of these organizations are usually more than willing to help!

For quick and immediate support – join in “our” forums @ www.bipolarandsupport.com

In the USA

We recommend you contact your local office of NAMI:

National Alliance for the Mentally Ill (NAMI)

[*]For a listing of local NAMI chapters check here: NAMI list of Local Chapters/Affiliates
[*]Depression and Bipolar Support Alliance ( previously called the National Depressive and Manic-Depressive Association)

In Canada Join the Mood Disorders Society of Canada

Here is a good example of a more progressive approach to providing information to the public,: PsychosisSucks

International Support Organizations:

Manic Depression Fellowship – U.K. based support and services organization

International Society for Bipolar Disorders- requires a membership fee to join, but has some info available for free as well

Dutch Association for Manic-Depressives (Netherlands) – site in Dutch only

Fundacion de Bipolares de Argentina (FUBIPA) – Spanish support organization and website w/ thirteen regional groups in Argentina

German Society for Bipolar Disorder – site in German only

Visit the World Fellowship for Schizophrenia and Allied Disorders – it is a worldwide support organization for family-oriented support groups.

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DOWNLOADS RESOURCES AND BOOKS

Posted on April 5, 2016 by JmaC
Psychosis Supports for Parents
A peer support website for families dealing with a loved one who has psychosis.
Get the Help Early
This website was developed by first-episode psychosis youth and parents with the help of dedicated family members who donated their talent, expertise and experience to create a partnership-based early psychosis resource.
British Columbia Schizophrenia Society (BCSS)
A number of excellent downloads are available on early psychosis intervention, schizophrenia, self-management and other topics. There is also a list of family support groups and educational programs and services available within BC.
Canadian Mental Health Association (CMHA)
Online resources include A Siblings Guide to Psychosis and information and brochures on a range of mental health problems.
Here to Help
The Here to Help website has a Family Self-care and Recovery from Mental Illness workbook plus a number of other self-care resources.
Centre for Addictions and Mental Health (CMHA)
Available for download: Promoting Recovery from First Episode Psychosis: A Guide for Families
The Early Psychosis Prevention and Intervention Centre (EPPIC) (Australia)
The website for the leading Early Psychosis program. A great deal of information and resources for both practitioners and the public.
International Early Psychosis Association (IEPA)
An international network for the study and treatment of early psychosis. Resources include publications, treatment manuals and links for clients and families.
The Prevention and Early Intervention Program for Psychoses (PEPP)
An Early Psychosis program based out of Montreal. Provides detailed manuals on program operations and research.

BOOKS:

Surviving Schizophrenia: A Family Manual
E. Fuller Torrey (HarperCollins, 2013 6th ed.)
Understanding Schizophrenia
Richard S.E. Keefe and Philip D. Harvey (Simon and Schuster, 2010)
The Bipolar Disorder Survival Guide
David J. Miklowitz (The New Guildford Press, 2002)
The Depression Workbook: A Guide for Living with Depression and Manic Depression
Mary Ellen Copeland (New Harbinger Publications, 2001)
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