Managing Suicidal Risk in Borderline Personailty Disorder

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Patients with borderline personality disorder (BPD) are often high users of health care and may present with multiple crises and minor incidents of self-harm or threats.1 As with the boy who cried wolf, inpatient consultants and health care providers may end up feeling manipulated and may not take suicide risk very seriously.
(MORE: Behavioral Dysinhibition: Impulsivity and Borderline Personality Disorder)

Ms A, a 22-year-old, was brought to the emergency department (ED) by ambulance; she had overdosed on zolpidem(Drug information on zolpidem). After detoxification in the ED, a psychiatric consultation was requested. Ms A told the consultant that she had had a bad day and simply took 5 extra zolpidem tablets to “go to sleep” and that “it was just a stupid thing to do.” While obtaining the history, the consultant noted that Ms A’s therapist had left for vacation 2 days earlier.
The consultant informed Ms A that her overdose was just a reaction to her therapist’s vacation, that she did not have a major mental disorder, and that she was going to be discharged. In response, Ms A became irate, “No one cares about me; I just tried to kill myself and you just want to get rid of me! If you don’t admit me, I’m going to walk in front of the next bus!”
Feeling manipulated but with no other options, the consultant admitted Ms A to the inpatient psychiatric unit. Once there, the staff noted that Ms A seemed cheerful, childlike, and cooperative. In the morning, however, Ms A angrily demanded to be discharged when she was refused a smoking pass. The inpatient psychiatrist questioned Ms A about the recent overdose and suicide threats; she stated that she never intended to carry out her threats but was just trying to get attention.
Although health care providers may not take the threat of suicide seriously in patients who have BPD, these patients are often serious about suicide. Long-term studies indicate that compared with controls, patients with BPD have an 8% to 10% increased risk of completed suicide, which is comparable to that of patients who have MDD and schizophrenia.2 Moreover, minor overdoses frequently represent ambivalent suicide intent, and episodes of non-suicidal self-injury are markers for suicide risk and predict future suicide attempts.3,4
Conscious “attention-seeking” behavior is rare, although both patients and health care providers may attempt to frame suicidal behavior that way. As with Ms A, patients may minimize the seriousness of their intent, stating it was just “attention-seeking,” or “I was just trying to sleep,” making it easy for health care providers to question the validity of their patients’ actions.
On the other hand, not every gesture or threat is an indication for a prolonged inpatient hospital stay. Patients may threaten suicide as a way of obtaining or extending hospital stays. A study by Gregory and Jindal5 of 100 consecutive inpatient admissions showed that factitious production of suicide ideation, gestures, and threats was common among women with BPD at the time of discharge. Suicide threats and behavior served as a means of justifying the seriousness of their condition to providers, and to themselves. Given this information, is the underlying message that we should take suicidal ideation and behavior seriously, but not too seriously? How can we understand suicide risk in BPD?

What is already known about suicide risk in patients with borderline personality disorder (BPD)?

■ Patients with BPD are at significant risk for completed suicide; episodes of non­suicidal self-injury predict future suicide attempts.

What new information does this article provide?

■ The article provides a model for understanding suicide risk and behavior in patients with BPD and how that affects clinician-patient interactions.

What are the implications for psychiatrists?

■ Minor overdoses or superficial cutting behaviors are not merely attention-seeking, even if the patient says they are. Are patients placing blame on themselves or on others for recent interpersonal difficulties? If you find yourself in conflict with the patient, realize that the patient likely has an internal conflict over the same issue. A good therapeutic alliance includes clear expectations and boundaries, helping patients build autonomous motivation, and helping patients verbalize experiences and emotions.

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Being in the Now

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A focus on the present, dubbed mind fullness can make you happier and healthier. Training to deepen your immersion in the moment works by improving attention.”

Pulling into a parking garage you notice you have no recollection how you got there.
On reaching the bottom of a page in the book , you are frustrated that you have failed to understand what you just read. In conversation, you suddenly become aware that you have no idea what the person speaking to you has just said.

These episodes are symptoms of a distracted mind. You were thinking about a vacation while reading a report or reliving a hurtful exchange with a friend instead of paying attention to the road or conversation.
Whether the mind journeys to the future or the past, whether the thoughts that whisked you away were useful, pleasant, or uncomfortable, the consequences are all the same. You missed the present, experience of the moment , as it was unfolding. Your mind was hijacked into mental time travel.

Distinct from deliberate daydreaming, our mind gets off track. Such mental meandering is tied to negative mood.
Chronic psychological stress, suffered by millions, may be built on a mind consumed by rumination, worry or fear about many topics. This type of diffused and unstable focus impairs performance too. In moments that demand quick decisions and action, the consequences of diverted attention and perception could be deadly.
The opposite of a wandering mind is a mindful one. Mindfulness is a mental mode of being engaged in the present moment without evaluating or emotionally reacting to it.

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A Purpose Driven Life

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A Purpose Driven Life?
Can I have one of those?
Living a purpose driven life is a huge key to happiness. It can help you work out how to be happy. You needn’t have a big life purpose but you need something to be striving for over the long term that determines your daily and weekly activities and feeds back to you whether you’re being ‘productive’ or not.
There is balance, to be sure, but if your purpose isn’t a driving force then you need to find a new purpose or put some energy behind it – either way, get yourself a proverbial kick up the butt.
Life Goals

Your life goals come about from your life purpose. Your purpose defines you and what your life is about, your goals are end results that you are working towards and they must be in line with your purpose. If you feel strongly about a life goal that doesn’t fit your purpose, either re-think your purpose or expand it to be broader. Then you’ll be on your way to a purpose driven life.

Life Path

Your life path is the direction that your life is going in. Think about what your life will be like 5, 10, 20 years from now if you continue with the status quo. Do you like it? What if you take the other direction(s) you’re thinking of – what will life be like then?
Talk to your future self, have a conversation, see what the ups and downs are like, the pros and cons. Decide if that’s where you want to be. The most important thing is to make decisions and move with them. Stagnancy by default is rarely a good idea and rarely makes you happy. What you need is a purpose driven life.

Life Balance

Life balance is NOT about work and play. It’s not about fitting in everything that society says you should be fitting in to your life. It’s about deciding the aspects of life that are important to YOU, that you know will make you a happy and whole individual. If your life until now has felt pretty lazy and unaccomplished and you’re feeling a drive to change, a few years of relatively intensive ‘work’ may be just what you need to find your life balance.
It’s not a matter of balancing your days and your weeks, but about doing what you think is best. If you have a spouse and/or children in your life, you do need to take them into consideration in your life balance plan but that doesn’t mean that you should neglect the needs of your life purpose. I firmly believe that in your pursuit of happiness, life balance should be looked at in terms of the big picture, not the nitty gritty of individual days or even weeks. It depends on your preferred working style.

Personal Development Plan
Creating a personal development plan can greatly help you in your pursuit of happiness. Decide what aspects of yourself and your life that you’d like to improve and then figure out the steps you need to take to improve those things and write them down. Create a daily, weekly, monthly plan, whatever you prefer. Set yourself achievable goals within specified time-frames. Do the research and education you need to be successful at your plan.
Don’t expect things to just ‘happen’. Find tools and techniques that you can put into action. Remember if you keep doing the things you’ve always done, you’ll get the same results that you’ve always got. If you want to get different results, you have to change what you do.

I do hope these ideas have helped you in your pursuit of a purpose driven life.

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Postpartum Depression

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What is postpartum depression?

Postpartum depression is a serious illness that can occur in the first few months after childbirth. It also can happen after miscarriage and stillbirth.

Postpartum depression can make you feel very sad, hopeless, and worthless. You may have trouble caring for and bonding with your baby.

Postpartum depression is not the “baby blues,” which many women have in the first couple of weeks after childbirth. With the blues, you may have trouble sleeping and feel moody, teary, and overwhelmed. You may have these feelings along with being happy about your baby. But the “baby blues” usually go away within a couple of weeks. The symptoms of postpartum depression can last for months.

In rare cases, a woman may have a severe form of depression called postpartum psychosis. She may act strangely, see or hear things that aren’t there, and be a danger to herself and her baby. This is an emergency, because it can quickly get worse and put her or others in danger.

It’s very important to get treatment for depression. The sooner you get treated, the sooner you’ll feel better and enjoy your baby.

What causes postpartum depression?

Postpartum depression seems to be brought on by the changes in hormone levels that occur after pregnancy. Any woman can get postpartum depression in the months after childbirth, miscarriage, or stillbirth.

You have a greater chance of getting postpartum depression if:
You’ve had depression or postpartum depression before.
You have poor support from your partner, friends, or family.
You have a sick or colicky baby.
You have a lot of other stress in your life.

You are more likely to get postpartum psychosis if you or someone in your family has bipolar disorder (also known as manic-depression).

What are the symptoms?

A woman who has postpartum depression may:
Feel very sad, hopeless, and empty. Some women also may feel anxious.
Lose pleasure in everyday things.
Not feel hungry and may lose weight. (But some women feel more hungry and gain weight).
Have trouble sleeping.
Not be able to concentrate.

These symptoms can occur in the first day or two after the birth. Or they can follow the symptoms of the baby blues after a couple of weeks.

If you think you may have postpartum depression, take a short quiz to check your symptoms:

A woman who has postpartum psychosis may feel cut off from her baby. She may see and hear things that aren’t there. Any woman who has postpartum depression can have fleeting thoughts of suicide or of harming her baby. But a woman with postpartum psychosis may feel like she has to act on these thoughts.

If you think you can’t keep from hurting yourself, your baby, or someone else, see your doctor right away or call 911 for emergency medical care. For other resources, call:
The national suicide hotline at 1-800-273-TALK (1-800-273-8255).
The National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453).

How is postpartum depression diagnosed?

Your doctor will do a physical exam and ask about your symptoms.

Be sure to tell your doctor about any feelings of baby blues at your first checkup after the baby is born. Your doctor will want to follow up with you to see how you are feeling.

How is it treated?

Postpartum depression is treated with counseling and antidepressant medicines. Women with milder depression may be able to get better with counseling alone. But many women need counseling and medicine. Some antidepressants are thought to be safe for women who breast-feed.

To help yourself get better, make sure you eat well, get some exercise every day, and get as much sleep as possible. Seek support from family and friends if you can.

Try not to feel bad about yourself for having this illness. It doesn’t mean you’re a bad mother. Many women have postpartum depression. It may take time, but you can get better with treatment.

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Helpful Resources

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Other helpful resources

AstraZeneca is doing what it can to help make it easier for you to get your medicines—even if you can’t afford them.

Here are some additional resources that may help you gain access to the medicines or services you need. This is not a complete list and is provided as a public service for health care providers, caregivers, and low-income patients.

Area Agencies on Aging (ElderCare)

Local area agencies on aging may be able to help patients age 65 years and older who cannot afford their medicines. To contact your local area agency on aging, call 1-800-677-1116 or visitwww.eldercare.gov.

Association of Clinicians for the Underserved (ACU)

The ACU is a nonprofit organization that works to help clinicians better serve the needs of low-income patients. The ACU has developed tools and links for implementing comprehensive pharmaceutical care for low-income patients. For more information, visit http://www.clinicians.org.

AstraZeneca Cancer Support Network

AstraZeneca developed the AstraZeneca Cancer Support Network (AZ CSN) as a support service to help meet the special needs of people undergoing treatment for cancer. The site offers help for patients who can’t afford their medicines, information on AstraZeneca cancer treatments, and personal support from oncology assistance specialists. If you would like to learn more about the services provided by AZ CSN, please call 1-866-99-AZCSN (1-866-992-9276). Oncology assistance specialists are available to provide expert advice in more than 150 languages. Help is available Monday through Friday, 8:00 AM–6:00 PM ET, excluding holidays.

BenefitsCheckUp®

The National Council on Aging (NCOA) sponsors this web site. It offers confidential assistance online for seniors and caregivers by searching more than 1,100 federal, state, and private prescription drug programs and determining those for which the senior may be eligible. For more information, visitwww.benefitscheckup.org.

Foundation for Health Coverage Information

The Foundation for Health Coverage Information web site provides simplified public and private health insurance eligibility information to the uninsured. The site also offers user-friendly tools and guides—booklets, pamphlets, toll-free Help Line, web tools and presentations—that simplify public and private health insurance options. For more information, visit http://www.coverageforall.org.

Health Resources and Services Administration (HRSA)

HRSA offers information about community health centers that may offer prescription assistance to low-income patients. Learn more by calling 1-888-ASK-HRSA.

Medicare

This official Medicare web site can help patients, caregivers, and doctors find information about public and private prescription drug assistance programs in their area, including eligibility requirements and covered services. For more information, visit http://www.medicare.gov.

My Medicare Matters

The My Medicare Matters web site is designed to help individuals learn more about Medicare prescription drug coverage. The web site was developed using materials from the Centers for Medicare and Medicaid Services, as well as materials developed by the National Council on Aging (NCOA), the Access to Benefits Coalition (ABC), and AstraZeneca. For more information, visitwww.mymedicarematters.org.

NeedyMeds

NeedyMeds is devoted to helping people in need find assistance programs to help them afford their medications and costs related to health care. The NeedyMeds web site provides information on company patient assistance programs, free and low-cost clinics, government programs and other types of assistance programs. For more information, visit http://www.needymeds.org.

Partnership for Prescription Assistance (PPA)

AstraZeneca also participates in the Partnership for Prescription Assistance (PPA), a national program that can help you find patient assistance programs. Qualifying patients who do not have prescription coverage can use the program as a single point of contact to access information about public and private programs that may be right for them. The PPA represents the largest-ever non-government-sponsored program to help bring medicines to Americans who do not have prescription drug coverage and are having difficulty affording their prescription medicines. More than 475 public and private patient assistance programs are available through the PPA. For more information, call the PPA toll-free phone number (1-888-4PPA-NOW) or visit http://www.pparx.org.

RxAssist

RxAssist lets you search for information on patient assistance programs by company, brand name, generic name, or type of medicine. RxAssist provides information on ways to get free and low-cost medications. The site also provides a quick-reference chart that lists drug assistance programs by state. For more information, visit http://www.rxassist.org.

RxHope™

RxHope lets you search for patient assistance information. In addition, some companies allow physicians to submit applications electronically through this site. For more information, visitwww.rxhope.com.

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6 Depression Traps to Avoid

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6 Common Depression Traps to Avoid

Expert advice on how to sidestep pitfalls that often accompany depression.

WebMD Feature

By Jennifer Soong

Reviewed By Louise Chang, MD

When Orion Lyonesse is getting depressed, she turns into a hermit. She doesn’t want to leave the house (not even to pick up the mail), and she cuts off contact with her friends and family.

“The more I’m alone, the deeper the depression gets,” Lyonesse, an artist and writer in Lake Stevens, Wash., tells WebMD in an email. “I don’t even want to cuddle my cats!”

Avoiding social contact is a common pattern you might notice when falling into depression. Some people skip activities they normally enjoy and isolate themselves from the world. Others turn to alcohol or junk food to mask their pain and unhappiness.

Depression traps vary from person to person, but what they have in common is that they can serve to worsen your mood, perpetuating a vicious cycle. Here are six behavioral pitfalls that often accompany depression — and how you can steer clear of them as you and your doctor or therapist work on getting back on track.

Trap #1: Social Withdrawal

Social withdrawal is the most common telltale sign of depression.

“When we’re clinically depressed, there’s a very strong urge to pull away from others and to shut down,” says Stephen Ilardi, PhD, author of books including The Depression Cure and associate professor of psychology at the University of Kansas. “It turns out to be the exact opposite of what we need.”

“In depression, social isolation typically serves to worsen the illness and how we feel,” Ilardi says. “Social withdrawal amplifies the brain’s stress response. Social contact helps put the brakes on it.”

The Fix: Gradually counteract social withdrawal by reaching out to your friends and family. Make a list of the people in your life you want to reconnect with and start by scheduling an activity.

Trap #2: Rumination

A major component of depression is rumination, which involves dwelling and brooding about themes like loss and failure that cause you to feel worse about yourself.

Rumination is a toxic process that leads to negative self-talk such as, “It’s my own fault. Who would ever want me a friend?”

“There’s a saying, ‘When you’re in your own mind, you’re in enemy territory,'” says Mark Goulston, MD, psychiatrist and author of Get Out of Your Own Way. “You leave yourself open to those thoughts and the danger is believing them.”

Rumination can also cause you to interpret neutral events in a negative fashion. For example, when you’re buying groceries, you may notice that the checkout person smiles at the person in front of you but doesn’t smile at you, so you perceive it as a slight.

“When people are clinically depressed, they will typically spend a lot of time and energy rehearsing negative thoughts, often for long stretches of time,” Ilardi says.

The Fix: Redirect your attention to a more absorbing activity, like a social engagement or reading a book.

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Sleeping

Jan. 26, 2011 — Spending too many nights tossing and turning? You may want to vacuum your bedroom, wash your sheets, and throw out that lumpy mattress before you reach for a sleeping pill.

Results from a survey commissioned by the National Sleep Foundation (NSF) suggest that people sleep much better when their bedrooms are comfortable and clean.

The group’s first ever “bedroom poll” surveyed sound sleepers and poor sleepers about how the bedroom environment affected their ability to get a good night’s sleep.

“We’ve looked a lot at how medical and behavioral issues affect sleep, but we really hadn’t looked at the sleep environment in such depth,” NSF Chief Operating Officer David Cloud tells WebMD. “Frankly, we were surprised to see that senses like touch, feel, and smell were so important.

Making Bed May Lead to Better Sleep
The survey included responses from 1,500 randomly selected adults in the U.S. between the ages of 25 and 55.

Less than half (42%) identified themselves as being “great sleepers” who got a good night’s sleep every night or almost every night.

Among the other findings:

Seven out of 10 people said they made their bed every day or almost every day. The bed-makers were 19% more likely to report getting a good night’s sleep on most days.
Nine out of 10 rated having a comfortable mattress and comfortable pillows as important for getting a good night’s sleep, while slightly less rated comfortable sheets and bedding as important.
Between two-thirds and three-fourths of respondents rated a cool room temperature; fresh air; and a dark, quiet, and clean room as important for a good night’s sleep.
Six out of 10 said they changed their sheets weekly or more often and roughly 3 out of 4 people said they got a more comfortable night’s sleep when their sheets had a fresh scent.
“People reported sleeping longer hours and feeling better about going to bed when their bed was made, their sheets were fresh, and their bedroom was comfortable,” Cloud says.

Sleep Environment Often Ignored
The survey responses come as no surprise to sleep psychologist Shelby Harris, PsyD, who directs the Behavioral Sleep Medicine Program at Montefiore Sleep-Wake Disorder Center in New York.

She tells WebMD that the sleep environment is an important, but largely ignored, component of a good night’s sleep.

While fluffed pillows and scented sheets are not likely to solve serious sleep problems, changing the bedroom environment to make it more comfortable can help occasional poor sleepers rest easier, Harris says.

She also recommends reserving the bed for just two things: sleep and sex.

“A lot of people watch TV in bed or pay their bills or even do their taxes, and then wonder why their minds continue to race when they want to go to sleep,” she says. “We encourage people to make their bedroom a sanctuary for sleep.”

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Medication Treatments for Bipolar Disorder

MEDICATION treatments for Bipolar Disorder:

1.quetiapine(Seroquel , Seroquel XR)
What is the most important information I should know about quetiapine? Seroquel 100 mg round, yellow, imprinted with SEROQUEL 100 Seroquel 200 mg round, white,… More
2.aripiprazole(Abilify , Abilify Discmelt)
What is the most important information I should know about aripiprazole? Abilify, Abilify Discmelt Abilify 10 mg rectangular, pink, imprinted with A-008 10 Abi… More
3.lithium(Eskalith , others…)
Drink extra fluids to keep from getting dehydrated while you are taking lithium. Tell your doctor if you have been sweating excessively, or if you are sick with fev… More
4.clozapine(Clozaril , FazaClo)
While you are taking clozapine, your blood may need to be tested every week for the first 6 months of treatment. Do not miss any scheduled blood tests. More
5.thioridazine(Mellaril )
Thioridazine is an anti-psychotic medication in a group of drugs called phenothiazines (FEEN-oh-THYE-a-zeens). It works by changing the actions of chemicals in your… More
6.risperidone(Risperdal , others…)
There may be other drugs not listed that can affect risperidone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes… More
7.olanzapine(Zyprexa , Zyprexa Zydis)
Olanzapine may cause you to have high blood sugar (hyperglycemia). Symptoms include increased thirst, increased urination, excessive hunger, and weakness. If you ar… More
8.fluoxetine(Prozac , others…)
SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have… More
9.sertraline(Zoloft )
Do not take sertraline together with pimozide (Orap), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azil… More
10.topiramate(Topamax , Topamax Sprinkle)
Topiramate is a seizure medication, also called an anticonvulsant. Topiramate is used alone or in combination with other medications to prevent seizures in adults a… More
11.divalproex sodium(Depakote , others…)
Divalproex sodium can cause birth defects. Do not use this medication without your doctor’s consent if you are pregnant. Use an effective form of birth control… More
12.buPROPion(Wellbutrin , others…)
Do not smoke at any time if you are using a nicotine product along with Zyban. Too much nicotine can cause serious side effects. More
13.paroxetine(Paxil , others…)
Paroxetine may cause heart defects or serious, life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may… More
14.clonazepam(Klonopin , Klonopin Wafer)
Clonazepam may cause harm to an unborn baby, and may cause breathing or feeding problems in a newborn. But having a seizure during pregnancy could harm both the mot… More
15.citalopram(Celexa )
Do not take citalopram together with a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (El… More
16.carbamazepine(Tegretol , others…)
There are many other medicines that could cause a drug interaction if you take them together with carbamazepine. Tell your doctor about all the prescription and ove… More
17.venlafaxine(Effexor , Effexor XR)
Venlafaxine is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Venlafaxine affects chemicals in th… More
18.lamotrigine(Lamictal , others…)
Do not stop taking lamotrigine without first talking to your doctor, even if you feel better. You may have increased seizures if you stop taking lamotrigine suddenl… More
19.haloperidol(Haldol , Haldol Decanoate)
Haloperidol What is the most important information I should know about haloperidol? Haloperidol 0.5 mg-MYL round, orange, imprinted with MYLAN 351 Haloperidol … More
20.valproic acid(Depakene , others…)
Valproic acid affects chemicals in the body that may be involved in causing seizures. Valproic acid is used to treat various types of seizure disorders. Valproic ac… More
21.gabapentin(Neurontin , Gabarone)
You may have thoughts about suicide while taking gabapentin. Your doctor will need to check you at regular visits. Do not miss any scheduled appointments. More
22.escitalopram(Lexapro )
Do not take escitalopram together with a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (… More
23.loxapine(Loxitane , Loxitane C)
What is the most important information I should know about loxapine? Loxapine 10 mg-MYL green/yellow, imprinted with MYLAN 7010 Loxapine 10 mg-WAT white/yellow… More
24.fluvoxamine(Luvox , Luvox CR)
You may have thoughts about suicide when you first start taking an this medication, especially if you are younger than 24 years old. Your doctor will need to check … More
25.duloxetine(Cymbalta )
Do not take duloxetine together with thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagili… More
26.ziprasidone(Geodon )
Pronunciation: zi PRAY si done Brand: Geodon Geodon 20 mg Slide 1 of 4Prev | Next blue/white, imprinted with PFIZER 396 Geodon 40 mg Slide 2 of 4Prev |Nex… More
27.oxcarbazepine(Trileptal )
Do not use this medication without your doctor’s consent if you are pregnant. It could cause harm to the unborn baby. Oxcarbazepine should not be used during p… More
28.isocarboxazid(Marplan )
There are many other medicines that can cause serious or life-threatening medical problems if you take them together with isocarboxazid. Do not take isocarboxazid b… More
29.perphenazine(Trilafon )
Do not use perphenazine if you have liver disease, brain damage, bone marrow depression, a blood cell disorder, or if you are also using large amounts of alcohol or… More
30.fluphenazine(Prolixin , others…)
Do not use fluphenazine if you have liver disease, brain damage, bone marrow depression, a blood cell disorder, or if you are also using large amounts of alcohol or… More
31.trifluoperazine(Stelazine )
Trifluoperazine is an anti-psychotic medication in a group of drugs called phenothiazines (FEEN-oh-THYE-a-zeens). It works by changing the actions of chemicals in y… More
32.thiothixene(Navane )
Thiothixene is an antipsychotic medication. It affects the actions of chemicals in your brain. Thiothixene is used to treat schizophrenia. Thiothixene may also be u… More
33.desvenlafaxine(Pristiq )
Desvenlafaxine is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). Desvenlafaxine affects chemicals … More
34.asenapine(Saphris )
What is the most important information I should know about asenapine? Before taking asenapine, tell your doctor if you have liver disease, heart disease, high … More

http://tools.aolhealth.com/treatments/bipolar-disorder__#medical
Click this link for MORE information on each medication

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Fact Sheet/Suicide/Mental Health

One in four adults-57.7 million Americans-experience a mental health disorder in a given year. One in 17 lives with a serious mental illness , such as schizophrenia, major depression, or Bipolar disorder and about one in ten children have a serious mental or emotional disorder.

-About 1.1% of the adult population live with schizophrenia.
-Bipolar disorder affects 5.7 million adults approximately 2.6% of the adult population per year
-Major depressive disorder affects 6.7% of adults, or about 14.8 million Amer. adults.This is the leading cause of disability in the U.S and Canada in ages between 15-44 years.

-Anxiety disorders which include panic disorder, OCD, PTSD, generalized anxiety disorder, and phobias, affect about 18.1% of adults an estimated 40 million individuals.Anxiety disorders co occur with depression.

-AN estimated 5.2 nmillion adults havve co-occuring mental health and addiction disorders. Of adults using homeless services , thirty one percent reported having a combination of these conditions.

-Half of all the lifetime cases of mental illness begin by age 14, three quarters by age 24 years. Despite effective treatments, there are long delays sometimes decades between frist onset of symptoms and when people seek and retrieve treatment.

-Fewer than one-third of adults and half of children with a diagnoseable mental disorder receive any mental health services in a given year.

– In the U.S, the annual economic, indirect cost of mental illnesses is estimated to be 79 billion. Most of that amount-approximately 63 billion-reflexs the loss of productivity as a result of illness.

-Individuals with serious mental illness face an increased risk of having chronic medical conditions. Adults with serious mental illness die 25 years younger than oyher Americans , largely due to medical conditions.

-Suicide is the 11th leading cause of death in the U.S and the third leading cause of death for ages 10-24 years. More than 90% die from suicide have a mental disorder.

-A nationwide report indicated that male veterans are twice as likely to die by suicide as compared with their civilian peers in the U.S

-Over 50 % of students with a mental disorder 14 years and older drop out of high school- the highest drop out rate of any disability group.

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Destination Recovery

DESTINATION RECOVERY;

If you live with mental illness, you may be struggling to find treatment, manage your medication and cope with life’s challenges effectively. There is ample cause for hope. You are not alone, help is available, mental health conditions are treatable, and you can take practical steps to recover your life.

There are many interactive tools and resources to help you better understand your treatment options by working closely with your health care provider, learn about the supports available to you, and start on your recovery journey. Getting treatment for your mental health condition is the first of many things you can do for your own recovery.

After receiving a diagnosis of mental illness, it is common to experience a range of emotions. For some people, a diagnosis can be a relief in that they are finally able to put a name to a problem. For others, it can be a major blow. They may experience fear, anger, denial, shame or sadness, or they may wonder, “Why did this happen to me?” “How will this affect my life?” or “What will people think of me?”
Being told that you have a mental illness is not the end of the world. With help and support, you can recover and achieve your life’s ambitions.

Of course, you will face many challenges as you begin your treatment, but there is hope. Mental illnesses are manageable. And there are a number of things you can do for yourself after a diagnosis to cope with the news, keep up with your treatment, and support your own recovery.

Be hopeful and Have Faith in yourself;

Above all else, it’s important to maintain a positive outlook. Here are a few things to keep in mind throughout your treatment and recovery:

You are not alone in this experience. Mental illnesses are common, affecting one in every five Americans.

You can improve and achieve your goals. Today, many people who are diagnosed with serious mental illnesses are managing their conditions and regaining control of their lives.

You can and should play an active role in your treatment. And the more informed you are about your illness and treatment options, the better you’ll be able to direct your recovery.
Learn all you can about your diagnosis.

If you’re ready, do some research on your particular illness, the recommended treatments, and other self-help ideas. The more you learn, the better you’ll be in working with your doctor and making decisions that feel right for you. Knowledge is necessary!

Again, talk to people who have had similar experiences, or mental health professionals you know and trust. The Internet can be a great resource for information about mental illnesses and treatment options. There are a number of websites, On-Line support groups such as Bipolar 4 Life Support, many organizations such as NAMI.org.

However, beware of websites that offer quick fixes, and never take the advice of any individual whether claiming to be a Dr. or what have you, always I can’t emphasize enough, before making any adjustments to your treatment call and speak with your Dr. ASAP, remember we are all equals, and may have the “same titled diagnosis” but we all differ when it comes to our treatment, meaning what works for one of us may not, or may be dangerous to another!

Get emotional support.

An important step in coping with a diagnosis is finding emotional support. Talk to friends and family members you feel close to and trust. They care about you and want to help you recover. Discuss your feelings about the diagnosis and any treatments or services that have been recommended.

Don’t be afraid to let people know how to help you. This support will be important, both as you begin your recovery and when you have to deal with any setbacks along the way. Also, you may want to meet people who have already been through what you are currently experiencing. This can help you prepare for what’s ahead
and help you avoid any problems others may have been through in their recovery.

This is where support groups and or organizations can be of help, whether it be on-line or locally near you it is important in anyone’s recovery to build a support system, the point is, don’t be afraid to reach out, you will be suprised after joining in one, or the other just how many people you will meet struggling through the same as you, and you can share, and learn from each others coping mechanisms. This will also take some of the feeling’s you may have of loneliness away as well, you don’t want to start to isolate.

Understand your health care options.

Getting the services you need and paying for them can be a challenge. Your options may be limited by whether or not you have insurance, the type of insurance you have, and the amount of coverage your plan provides for mental health care. There also may be a shortage of mental health professionals where you live, and it can be tough to get an appointment. But, remember, there are options.

Follow the steps below to learn more about your options:

If you’re employed and have a health plan, call your health insurer to see if they cover mental health services. Then find out which mental health professionals in your area are willing to accept your insurance plan.

If you get health care through a government program like Medicaid or Medicare, you should contact a community mental health center or local health department to see which doctors or programs accept this form of health insurance.

If you don’t have health insurance, ask your community mental health center about reduced-cost (or sliding- scale fee)
Develop a partnership with your doctor and/or therapist.
Once you have received a diagnosis and are in contact with a doctor or a mental health professional, here’s what you need to know about making the most of these relationships from the start:

Make sure it’s the right fit for you. If possible, interview multiple Doctors, don’t be afraid to meet with more than one. Although going at this alone is extremely difficult, that is one of the reasons a support system is vital! You’ll want to find a doctor, mental health professional or peer counselor with whom you can relate. Ask them about what treatment’s they have used in the past with other patients in which had the most success, and experiences helping other people with your particular illness.

Be open with your doctor or therapist.

Share how you’re really feeling. Go to your appointments with a list of questions you may have about your
diagnosis, Mood Tracking/Charting is a great asset for you, by being able to reflect back when feelings come upon you, and you learn to notice your Triggers, as well as show the Psychiatrist treating you, and or Therapists when there is loss of memory, and or find it hard to Voice, sometimes writing it down is easier than explaining it verbally.

After starting a course of treatment, you should begin to notice changes: relief from your symptoms, greater self esteem-confidence, and greater ability to make decisions. You should tell the doctor or therapist about your progress, or if you are having any problems. Don’t be afraid to voice your concerns.

You can find a Mood Tracker/Chart on Bipolar 4 Life Support Home Page @

http://www.bipolar4lifesupport.com

See the “Tab Mood Chart” it is a printable version, and very simple to use, with much space for writing.

If you prefer to make a list of questions than do so, it is all about whatever works for you in your recovery!

Involve your family and friends in your treatment, if you’re comfortable with that. Invite them to accompany you to an appointment, or to sit in on a therapy session.

Getting the right help requires Self-Advocacy. Take advantage of the options you have and continue to search for other ways to meet your needs.

Remember – getting back to your life is the GOAL to RECOVERY:)

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