A Newsletter from www.MentalMeds.org

Issue 4

Dear Reader,

If you think this newsletter is late, you are right. (I blame DSL problems and business travel.) Here it is, at last, and hopefully better late than never.

Please send all correspondence to meds@MentalMeds.org. If you are submitting material for the site or newsletter, include your URL or any other contact information you wish to appear, and I'll include it. (Just be careful to tell me what you want to appear, and what you do not want to appear!)

Kevin Thompson, Ph.D.
Editor

P.S. As always, if you do not wish to receive email from me, please let me know, and I will remove your name from my list.

Table of Contents

Calling for Articles
Humor
Psychosis and Schizophrenia: Whose Reality is This, Anyway?
Book News
Spotlight on Resources: CNS Response
Are You Looking for Writers?

Calling for Articles

Do you have experiences you would like to share about how you have coped with mental illness? Uplifting stories? Educational stories? Email me with your idea, and if it makes sense, I will be happy to include it in a future issue.

Humor

More funny stuff from around the Internet.

A depression joke, from Basic Jokes

A businessman was in a great deal of trouble. His business was failing, he had put everything he had into the business, he owed everybody-- it was so bad he was even contemplating suicide. As a last resort he went to a priest and poured out his story of tears and woe.
    When he had finished, the priest said, "Here's what I want you to do: Put a beach chair and your Bible in your car and drive down to the beach. Take the beach chair and the Bible to the water's edge, sit down in the beach chair, and put the Bible in your lap. Open the Bible; the wind will rifle the pages, but finally the open Bible will come to rest on a page. Look down at the page and read the first thing you see. That will be your answer, that will tell you what to do."
    A year later the businessman went back to the priest and brought his wife and children with him. The man was in a new custom-tailored suit, his wife in a mink coat, the children shining. The businessman pulled an envelope stuffed with money out of his pocket, gave it to the priest as a donation in thanks for his advice.
    The priest recognized the benefactor, and was curious. "You did as I suggested?" he asked.
    "Absolutely," replied the businessman.
    "You went to the beach?"
    "Absolutely."
    "You sat in a beach chair with the Bible in your lap?"
    "Absolutely."
    "You let the pages rifle until they stopped?"
    "Absolutely."
    "And what were the first words you saw?"
    "Chapter 11."

From Mental Jokes.

Psychiatrist, to his nurse: "Please just say we're very busy. Don't keep saying it's a madhouse in here!"

Cop's Toilet has nothing to do with mental illness, but I can't resist it .

Did you hear that someone broke into our local police station and stole the toilet? Right now the cops have nothing to go on.

Send me your favorite joke, funny story, or amusing picture, as long as it is related to mental illness. Keep it upbeat, please! Jokes involving mental illness are welcome, but jokes that demean mental illness are not. If it's appropriate, I'll put it up on the humor page.

Psychosis and Schizophrenia: Whose Reality is This, Anyway?

by Kevin Thompson, Ph.D. Available here.

We all receive information about the world through our senses, in a manner that seems unremarkable. Our common sensory experiences enable us to build models of reality that are similar, and this shared understanding helps us to live and work together in a reasonably smooth fashion.

These models are not completely consistent with each other, of course, or we would not have different beliefs. We also wouldn't make the common mistake that just because we believe something, everyone else should believe it, too! However, these differences are the result of different priorities and thought processes, not disagreement about the reality we perceive through our senses.

Yet not everyone shares this consensus. Some people perceive a reality that is both quite different from the norm, and has elements that are clearly wrong. They suffer from a set of symptoms called "psychosis."

The most dramatic symptoms of psychosis are hallucinations (false perceptions), and delusions (false beliefs).

Hallucinations are sensory perceptions that do not originate in physical reality. Because these are perceived as coming from the senses, it can be difficult for the person to tell that they are not real. Hallucinations can take the form of false images, sounds (often voices), physical touch, or even smell and taste.
Delusions are powerful beliefs that are clearly wrong and impervious to evidence. Delusions are often paranoid in nature, with individuals believing, for example, that secret government agencies are spying on them, or trying to control their minds.

Hallucinations and delusions are the primary symptoms of psychosis. They are often accompanied by an inability to recognize that anything is wrong. This lack of insight, which is called anosognosia, makes treatment very difficult.

People who are in the grips of a severe psychotic episode seem "crazy" to onlookers, but their behavior makes perfect sense from the right perspective: The psychotic person is responding rationally to experiences that the rest of us do not share.

Psychotic episodes can arise from many different reasons. Many illegal drugs and prescription medications (such as cocaine and amphetamines), taken at a large enough dose, can cause psychotic symptoms. Psychotic episodes can also occur during severe manic episodes, for people who have bipolar disorder. However, the illness most associated with psychosis is schizophrenia.

Schizophrenia is a very serious illness. While it includes psychosis as the most obvious set of symptoms, this illness often causes severe suppression of the normal range of emotions as well. The blunted emotions can rob the ill person of all joy in life, and produce a strange, almost emotionless style of behavior ("flattened affect") that is very disturbing to others.

Treatment for schizophrenia is less advanced, and less satisfactory, than for depression and bipolar disorder. The newest generation of "atypical" antipsychotic medications does a better job in treating schizophrenia than the older "typical" antipsychotics, but is far from ideal. On the positive side, these medications frequently help with both psychosis and blunted emotions. On the negative side, they seldom do a perfect job of either, and the side effects can be severe. Side effects include diabetes, permanent movement disorders (such as Tardive Dyskinesia), Parkinsonism, serious weight gain, depression, and sexual dysfunction.

Treatment for psychosis arising from bipolar disorder tends to be more successful, partly because the psychosis is more episodic than for schizophrenia, and partly because there are fewer to treat. Atypical antipsychotics are used in this case as well, so while the treatment may work, the side effects remain as significant problems.

The bad news is that much remains to be done in understanding and treating psychosis, in all the cases where it arises. The good news is that the last few decades have seen much progress, and more will come..

Kevin Thompson, Ph.D. is the author of Medicines for Mental Health: The Ultimate Guide to Psychiatric Medication. You can find information about treatments for depression, bipolar disorder, schizophrenia, and sexual problems on his Web site at www.MentalMeds.org.

Book News

I mentioned in the last newsletter that I was working with a Public Relations consultant to notify major periodicals, distributors, and other interested parties that Medicines for Mental Health is available in online bookstores. As a result, the American Psychiataric Association and the Psychiatric Times will be reviewing my book. So if you are a member of the former, or subscribe to the latter, keep your eyes open for a book review!

Spotlight on Resources: CNS Response

CNS Response is a company that is in the forefront of developing objective diagnostic techniques for mental illness. They have pioneered a technique known as Referenced-EEG^®(rEEG ^® for short), which has two intriguing characteristics.

First, the technique uses a variation on electroencephalogram (EEG) technology to collect information about electrical activity in different parts of the patient's brain. A computer program then compares the recorded information to a large database of similar recordings, obtained from people who have normal and abnormal mental-health, and who were taking a variety of different medications. The program performs a statistical analysis to derive useful information about the patient's condition.

Second, in an unusual twist, the analysis provides not a diagnosis, but a prediction about the medications that should be the most useful in treatingn the disorder. This seems counterintuitive, at first. After all, diagnosis has been the central pillar of medical science from day one, so how can we treat an illness that we do not diagnose? Yet we routinely treat problems that lack a formal diagnosis (headaches, for example), because we select medications that treat a particular set of symptoms. So this approach is not as unfamiliar as it seems, at first.

The novelty of the rEEG technique lies partly in its elimination of the diagnostic paradigm for treatment, but primarily in providing any kind of objective test for use in psychiatry. The use of any objective analytical technique in psychiatry is new, and something of a culture shock for psychiatrists. How well the field can adapt to this concept may well be as important for its success as how well the technique can be shown to work.

Referenced-EEG ^® and rEEG ^® are registered trademarks of CNS Response.

Are You Looking for Writers?

If you are looking for articles on mental-health and medication issues, for an online or printed publication, send me a note. I write for various publications, and may be able to help.