We now know that many disorders are physiological, not psychological

Exhaustion weighs her down until she gets out of bed. Trudging to the shower and going down the grocery store aisles feel like a long slog through dark molasses.

By the numbers

Who are the mentally ill? They are our neighbors, friends, family — and us. Put five people in a room and one has suffered from a mental illness in the past year.

One in five adults (46 million Americans) experiences mental illness each year.

One in 17 suffers serious mental illness such as schizophrenia, major depression or bipolar disorder.

One in 10 children lives with a serious mental or emotional disorder.

The rate of mental illness is more than twice as high among those aged 18 to 25 (29.9 percent) than among those 50 and older.

Less than one-third of adults and half of children with a diagnosable mental disorder receives mental health care in a given year.

Half of all lifetime cases of mental illness begins by age 14, three-quarters by 24.

More than 50 percent of students 14 and older with a mental disorder drop out of high school — the highest dropout rate of any disability group.

24 percent of state prisoners and 21 percent of local jail prisoners have a recent history of mental illness.

70 percent of children in juvenile justice systems have at least one mental disorder.

The annual economic, indirect cost of mental illness in the U.S. is about $79 billion, mostly in lost productivity.

Adults living with serious mental illness die 25 years earlier than other Americans, largely due to treatable medical conditions.

An estimated 8.7 million American adults had serious thoughts of suicide in the past year. Of them, 2.5 million made suicide plans, and 1.1 million attempted suicide.

Sources: Substance Abuse and Mental Health Services Administration, National Alliance on Mental Illness, National Institute of Health, U.S. Department of Health and Human Services, National Center for Mental Health and Juvenile Justice

The heaviness caused by major depression has come and gone throughout Lisa Livingston Baker’s life. And when her husband died in 2008, she could not even lift her body from her bed.

Major mental illnesses

Mental illness refers to a wide range of disorders that affect mood, thinking and behavior. More common ones include:

Attention-deficit/hyperactivity disorder: Characterized by inattention, hyperactivity and impulsivity. Strong scientific evidence indicates ADHD is a biologically based disorder. Research also suggests a strong genetic basis.

Bipolar disorder (formerly known as “manic-depressive disorder”): A major mood disorder in which a person experiences episodes of depression and mania (extreme irritability or euphoria). Likely caused by an imbalance of neurotransmitters or hormones. Trauma and major loss may play roles.

Major depression (known as clinical depression): A combination of depressed mood, poor concentration, insomnia, fatigue, appetite disturbances, excessive guilt and suicidal thoughts. Depression is twice as common in women for reasons not fully understood. Likely caused by biological differences in the brain along with trauma or major loss.

Post-traumatic stress disorder: Severe or repeated exposure to trauma can affect the brain in a way that makes a person feel like the event is happening again and again. Can induce anxiety, sleeplessness, anger or substance abuse. PTSD can affect everyone from survivors of sexual trauma and natural disasters to emergency and rescue personnel and military veterans.

Generalized anxiety disorder: A severe, chronic, exaggerated worrying about everyday events. Likely caused by genetics, brain chemistry and environmental stresses.

Obsessive-compulsive disorder: Obsessions are intrusive, irrational thoughts or impulses that repeatedly well up in a person’s mind. Compulsions are repetitive rituals such as handwashing, counting, checking, hoarding or arranging. Evidence suggests that OCD is caused by a chemical imbalance in the brain. People whose brains are injured also can develop OCD.

Panic disorder: Feelings of terror that strike suddenly and repeatedly with no warning. Symptoms include sweating, chest pain and irregular heartbeats. More common in women. Brain abnormalities, family history, major life stress and abuse of drugs and alcohol may play roles.

Schizophrenia: A group of severe brain disorders in which people interpret reality abnormally. May result in hallucinations, delusions and disordered thinking and behavior. Likely caused by differences in the brain, genetic vulnerability and environmental factors that occur during a person’s development.

Personality disorders

Borderline personality disorder: Characterized by unstable moods, interpersonal relationships, self-image and behavior.

Antisocial personality disorder: A person’s thinking and relating to others are abnormal and destructive, such as disregard for right and wrong, lying and behaving violently.

Narcissistic personality disorder: Characterized by an inflated sense of self-importance and a deep need for admiration.

Personality disorders are thought to be caused by genetic and environmental factors.

Sources: National Alliance on Mental Illness, Mayo Clinic, WebMD

She blamed herself.

First in a series

The mentally ill are under pressure and scrutiny like never before. Mental health budgets have been slashed. State inpatient beds are at historic lows. Emergency rooms and jails are the new front lines of care. In the wake of mass shootings — and would-be school shooters such as Alice Boland — some want registration of the severely ill.

But there is promise for change. State funding may increase. Research is showing these illnesses are based in flawed physiology, not character flaws. And many who suffer are challenging the stereotypes that affect them.

The Post and Courier is examining these issues in a series of stories over the next few months. We start with the stigma and its undercurrent of shame.
Join the discussion about this story and other mental health issues at Jennifer Berry Hawes’ Facebook group.

The master’s-educated teacher struggled to raise her three girls as she took medications and entered therapy. Books and tapes about coping amassed beneath her bed.

“I’ve done it all,” the Summerville mom sighed. “And how many more Lisas are out there?”

Millions. One in four adults experiences mental illness in a given year. One in 17 suffers serious mental illness such as schizophrenia, major depression or bipolar disorder, according to the U.S. Department of Health and Human Services.

And at perhaps no other time have they received more public attention than today.

Megachurch Pastor Rick Warren’s son committed suicide a week ago after a long battle with major depression.

Lawmakers are debating mental health care funding, gun control and registries of the mentally ill. And last week, 9th Circuit Solicitor Scarlett Wilson voiced doubt that the state can fully rehabilitate the violent mentally ill.

What does all this attention mean for the average person with a mental illness, suffering amid a public that stigmatizes them?

Baker can’t count how often she’s heard:

Buck up. Get over it. Just cheer up!

“People make you feel bad about yourself — and you make you feel bad about yourself,” Baker said. “I’m not a bad person. I’m not lazy or weak. I’m a good person. I’m trying.”

She recently joined a clinical trial at the Medical University of South Carolina that administers a brain stimulation treatment based on researchers’ improving knowledge of the brain as a highly complex electro-chemical organ, one that can malfunction just like any body part.

After receiving most of her treatments, Baker can laugh again. She even tackled her taxes.

And it’s not just the relief. The boost proves to her that the depression is caused not by personal failure, as stigma insinuates, but rather by malfunctioning brain circuitry.

It’s proof that the illness isn’t her fault.

Biology trumps

Dr. Mark George trained in psychiatry and neurology. He doesn’t see a distinction between the two.

Both deal with disorders caused by dysfunctional brain circuitry. So why are neurological disorders — Parkinson’s disease, for instance — viewed without the stigma that clouds others like depression and bipolar disorder?

“Stigma is really hard for me to deal with. I’ve trained across these disciplines, and to me it’s all the same,” said George, director of MUSC’s Center for Advanced Imaging Research and its Brain Stimulation Laboratory.

Stigma stems from historical misunderstandings, such as when people thought the mentally ill were inherently weak-minded or evil, or when George’s medical school professors taught that the brain was a fixed organ, incapable of changing and repairing itself.

Not true.

Modern imaging technology is allowing researchers to track the brain’s activity and to examine its wiring, structures and tissue micro-architecture to see exactly what is going on inside a living, thinking organ.

It has revolutionized knowledge of psychiatric disorders.

“The brain is really the last frontier in medicine,” George said.

What is now clear to researchers is that malfunctioning brain circuitry, and its interplay with genetics, trauma and environmental stress, plays a major role in many illnesses, including depression, anxiety and addictions. A new mantra rising among medical professionals calls mental illnesses “brain disorders.”

“We have these powerful imaging tools so we can see all of these things,” George said. “This new understanding should make people wake up to stigma.”

For instance, when imaging showed differences in the brains of people with attention deficit hyperactivity disorder, it indicated that the problem wasn’t bad parenting or a lack of discipline. It was based in physiology.

“That was huge. Imaging can add that legitimacy,” said Joseph A. Helpern, professor and vice chairman for research in radiology and endowed chair in brain imaging at MUSC.

Today, MUSC psychiatry is the largest research department in its College of Medicine, and is especially known for research of addictions and imaging techniques. And just this month President Barack Obama announced his BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative to map the brain’s activity in unprecedented detail.

So much research promises better understanding of this final frontier, and new treatments for when its circuits malfunction.

“In mental illness and addiction, the brain is different,” said Rhonda Faughender, clinical director for adult services at Palmetto Behavioral Health System. “But we can retrain our brains.”

Which means there is hope for people like Baker.

Biology of change

Baker sits in a small room in the Institute of Psychiatry lying on what resembles a dentist’s chair.

Dr. Baron Short, clinical director of MUSC’s Brain Stimulation Services, positions a plastic block containing an electromagnetic coil onto the upper left area of Baker’s forehead. She wears neon yellow earplugs to block out the rapid and fairly loud tapping of electrical pulses that penetrate her scalp and skull.

Brain tissue lacks pain receptors, so she can’t feel where the pulses penetrate into her prefrontal cortex, the upper front area of the brain.

Coils pulse for four seconds, then quiet for 20. The sensation on her skin is irritating but not painful, Baker said, like getting snapped by a rubber band.

Transcranial Magnetic Stimulation, recently approved by the FDA for the treatment of depression, aims to rouse the prefrontal cortex. It is considered the brain’s CEO, responsible for abstract thinking and regulating behavior and emotions, and it tends to be underactive in people with depression.

This underactivity, in turn, appears to affect the brain’s limbic system, a primitive area often called the “feeling and reacting brain” that is important in memory formation. This area tends to be overly active in people with depression.

“We’re helping the brain re-regulate itself,” Short explained.

Brain stimulation may hold promise in treating other illnesses, including addiction, which imaging indicates is another form of brain disorder. This also could change societal views of addiction — after all, when it comes to stigma, few disorders carry more shame than drug addiction, George said.

Yet it appears that some people are predisposed to addiction due to overly active brain regions that control craving and desire, while impulse-control areas are not as active. Researchers are testing ways to correct this circuitry just as they are with depression and other illnesses.

On Monday, George and a team of researchers will publish a study in the journal Biological Psychiatry that showed high-frequency TMS significantly reduced nicotine craving even in heavy smokers.

“People still think it’s about bad behavior and not an illness,” George said. “But it’s not you. It is a part of the brain that needs to exercise differently.”

Surviving stigma

Today, when someone is released from a psychiatric hospital, there are no sympathy cards in the mail, no meals provided by friends, no flowers or well-wishers eager to visit.

Often, there is only the suffocating silence of fear and rejection.

“We as a people don’t look at mental illness as an illness. If we just pull up our bootstraps and go, we can go. And it’s so untrue. It’s an illness just like heart disease or cancer,” said Wanda Brockmeyer, emergency services director for Roper St. Francis Healthcare.

When Baker turned 50 recently, she cried.

“This isn’t where I wanted to be,” she said. Then she reminded herself: I’m not a loser.

She wonders if others see her that way.

“Imagine if you said to a person, ‘If you had only been stronger, you wouldn’t have gotten cancer,’” Baker said.

She agreed to share her story here to challenge the stigma, to remind people that those with mental illness are parents, children, neighbors. And that their illnesses aren’t their fault.

Reach Jennifer Hawes at 937-5563, follow her on Twitter at @JenBerryHawes or subscribe to her at facebook.com/jennifer.b.hawes.

Beyond OCD Co-Sponsors National Stress Out Day

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Beyond OCD Co-Sponsors National Stress Out Day

Chicago, IL (PRWEB) April 12, 2013

Jeanne Ettelson, president of Beyond OCD, announced that Beyond OCD is co-sponsoring National Stress Øut Day, along with Active Minds and Anxiety and Depression Association of America, with support from the National Suicide Prevention Lifeline.

Next week college students on over 200 campuses across the country are participating in the 8th annual National Stress Øut Day—a nationwide effort to provide pre-finals stress relief and to educate students about the difference between everyday anxiety and anxiety disorders or other mental illness. This year National Stress Øut Day is being held during the week of April 14-20, 2013.

Anxiety disorders are one of the most common mental health problems on college campuses. Forty million U.S. adults suffer from an anxiety disorder, and 75% of them experience their first episode of anxiety before age 22, according to Active Minds. A recent national survey by the Higher Education Research Institute at UCLA found first-year college students’ self-ratings of their emotional health dropped to record lows in 2010. And a 2009 survey by the American College Health Association found that 46% of college students said they felt “things were hopeless” at least once in the previous 12 months, and nearly a third of college students had been so depressed that it was difficult to function.

During National Stress Øut Day, Active Minds chapters will invite students to participate in stress relieving activities like water balloon fights, petting zoos, and yoga. They will also be educated about mental health issues and made aware of the mental health resources available to them. National Stress Øut Day aims to shed light on anxiety disorders while promoting a healthy dialogue around all mental health issues.

Founded in 1994, Beyond OCD works to increase public and professional awareness of OCD, educate and support people with OCD and their families, and to encourage research into new treatments and a cure. Beyond OCD is dedicated to improving the lives of people who suffer with OCD—a resource for individuals, families, mental health professionals, educators, clergy and the media across the country.

OCD is a neurobiological anxiety disorder characterized by obsessions and compulsions that take up an excessive amount of time (typically an hour or more each day), cause significant distress and significantly interfere with normal life. Obsessions are uncontrollable, persistent worries, doubts, or fears, and compulsions are the repetitive activities that the person with OCD feels compelled to engage in to relieve the anxiety caused by the obsessions.

For more information on Beyond OCD or Obsessive Compulsive Disorder, visit http://www.BeyondOCD.org. On its web site, the organization offers detailed facts about OCD, resources, expert perspectives, personal stories from individuals with OCD, and free, downloadable OCD Guides in English and Spanish such as Overcoming OCD: A Guide for College Students.

For specific information on OCD in school, parents and educators may visit http://www.OCDeducationstation.org. People can also call Beyond OCD at 773-661-9530 to speak with someone knowledgeable about Obsessive Compulsive Disorder.        

Beyond OCD

2300 Lincoln Park West, Suite 206B

Chicago Il 60614

Ellen Sawyer, Executive Director

773-661-9530

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A Seasonal Pattern to Mental Health

A new study using the patterns of Google search queries suggests that mental illnesses flourish in winter and decline in summer.

In both the United States and Australia, researchers found distinct seasonal patterns, high in winter and low in summer, in searches pertaining to anxiety, obsessive compulsive disorder, bipolar disorder, eating disorders, depression, suicide, attention deficit hyperactivity disorder and schizophrenia. The study appears in the May issue of The American Journal of Preventive Medicine.

Searches related to eating disorders varied the most — 37 percent higher in winter than summer in the United States and 42 percent higher in Australia. The smallest variations were in searches related to anxiety: 7 percent and 15 percent more common in winter than summer in the United States and Australia, respectively. The variations persisted after he researchers controlled for seasonal differences in Internet use, mentions of the diseases in news articles and other factors.

Why this happens, and whether it is connected to increased incidence, is unclear, but it is known that varying hours of daylight, variations in physical activity and seasonal changes in blood levels of vitamin D and omega-3 fatty acids can affect mood.

“We have new kinds of data with which we can start to think about seasonality,” said the lead author, John W. Ayers, a research professor at San Diego State University. “This is just the beginning of a new research agenda.”

Seasonal Patterns Found in Online Mental Illness Searches

Seasonal Patterns Found in Online Mental Illness Searches  Online searches for all major mental illnesses tend to follow seasonal patterns, according to a new study — suggesting that mental illnesses may be more strongly linked with seasonal patterns than previously thought.

Monitoring population mental illness trends has been an historic challenge for scientists and clinicians alike. Telephone surveys have been the primary method to determine the prevalence of mental issues, but this approach is limited because respondents may be reluctant to honestly discuss their mental health.

This approach also has high material costs and a low return rate. As a result, investigators have not had the data they need.

In the study to be published in the May issue of the American Journal of Preventive Medicine, researchers now believe the Internet, and specifically Google, can provide an accurate barometer of mental health trends.

“The Internet is a game changer,” said lead investigator John W. Ayers, Ph.D. “By passively monitoring how individuals search online we can figuratively look inside the heads of searchers to understand population mental health patterns.”

Using Google’s public database of queries, the study team identified and monitored mental health queries in the United States and Australia for 2006 through 2010.

All queries relating to mental health were captured and then grouped by type of mental illness, including ADHD (attention deficit-hyperactivity disorder), anxiety, bipolar, depression, eating disorders (including anorexia or bulimia), OCD (obsessive-compulsive disorder), schizophrenia, and suicide.

Using advanced mathematical methods to identify trends, the authors found all mental health queries in both countries were consistently higher in winter than summer.

The research showed eating disorder searches were down 37 percent in summers versus winters in the U.S., and 42 percent in summers in Australia. Schizophrenia searches decreased 37 percent during U.S. summers and by 36 percent in Australia.

Bipolar searches were down 16 percent during U.S. summers and 17 percent during Australian summers; ADHD searches decreased by 28 percent in the U.S. and 31 percent in Australia during summertime. OCD searches were down 18 percent and 15 percent, and bipolar searches decreased by 18 percent and 16 percent, in the U.S. and Australia respectively.

Searches for suicide declined 24 and 29 percent during U.S. and Australian summers and anxiety searches had the smallest seasonal change – down 7 percent during U.S. summers and 15 percent during Australian summers.

Researchers said they were startled by the discovery of apparent seasonal trends for mental illness.

While some conditions, such as seasonal affective disorder, are known to be associated with seasonal weather patterns, the connections between seasons and a number of major disorders were surprising.

“We didn’t expect to find similar winter peaks and summer troughs for queries involving every specific mental illness or problem we studied,” said co-author James Niels Rosenquist, M.D., Ph.D. “However, the results consistently showed seasonal effects across all conditions – even after adjusting for media trends.”

“It is very exciting to ponder the potential for a universal mental health emollient, like Vitamin D (a metabolite of sun exposure). But it will be years before our findings are linked to serious mental illness and then linked to mechanisms that may be included in treatment and prevention programs,” said Ayers.

“Is it biologic, environmental, or social mechanisms explaining universal patterns in mental health information seeking? We don’t know.”

“Our findings can help researchers across the field of mental health generate additional new hypotheses while exploring other trends inexpensively in real-time,” said Benjamin Althouse, a doctoral candidate at Johns Hopkins Bloomberg School of Public Health and researcher on the study.

“For instance, moving forward, we can explore daily patterns in mental health information seeking … maybe even finding a ‘Monday effect.’ The potential is limitless.”

Source: Elsevier

Abstract of person and light photo by shutterstock.

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The Many Faces of Eating Disorders

 

At a time when over 35 percent of American adults are considered overweight — according to a statistic from the Center for Disease Control — and obesity has been implicated in heart disease, stroke and certain cancers, the current trend in American public health has been to promote weight loss.

It’s this inclination that UCSD professor and clinical therapist Danielle Beck-Ellsworth, who teaches a class on the psychology of eating disorders, says that diseases at the other end of the spectrum — anorexia nervosa, bulimia and binge eating — have escaped the limelight. 

Collectively, however, these diseases have the highest mortality rates out of any mental illness, according to statistics released by the national eating disorders association.

“It’s something that hasn’t really been on the radar,” Beck-Ellsworth said. “On a social level, we’re not really obsessed about eating disorders the way we are about obesity. But ironically, the more we stress weight loss, the more we may be encouraging unhealthy eating habits. Instead of focusing on weight, we need to be promoting a healthy lifestyle.”

Beck-Ellsworth warns individuals about drawing conclusions from eating disorder statistics, sufferers tend to share a number of personality traits. Individuals struggling with an eating disorder is often very rigid and motivated and have a very reward-dependent mindset. 

Studies have also shown that eating disorders can be triggered by traumatic events. But likely the most talked about cause of eating disorders as of late is the cultural pressure created by the concept of equating skinny with pretty.

Co-founder of the Summit Eating Disorders and Outreach Program in Sacramento Jennifer Lombardi, a survivor of anorexia nervosa, said that more research on the subject has revealed a number of trends emerging amongst college-aged sufferers of eating disorders. Lombardi said that college students may be put at particular risk because of the stress of a new environment and the cultural expectations associated with coming to college.

“Going to college is a very exciting time,” Lombardi said. “There’s a lot of emphasis put on having a wonderful time and becoming more independent, but rarely do we talk about how stressful that change may be. For someone with the acknowledged personality traits associated with eating disorders — the anxiety, in part caused by the myth of the Freshman 15 … may be enough to cause individuals to turn to that kind of behavior.” 

Characteristic of a number of psychological diseases, eating disorders are difficult to both diagnose and treat, because they’re caused by an array of issues — biological, social and cultural. 

From an anatomical standpoint, the excess or lack of specific chemical messengers, known as neurotransmitters, in the brain have been implicated. For this reason, individuals diagnosed with an eating disorder often also suffer from either obsessive-compulsive disorder or depression. A treatment option may include the prescription of antidepressants.

“There are a lot of contributing factors in the development of an eating disorder,” Lombardi said. “Biological risk factors, psychological predisposition, a family history of anxiety or obsessive-compulsive traits and temperament all sort of co-mingle.”

Lombardi regularly deals with sufferers of the disorder at her treatment center. She corroborated a study on “drunkorexia” published in 2011 by the University of Missouri. The authors of the study coined the term “drunkorexia” to describe individuals who forgo food in order to consume calories in the form of alcohol. According to the online questionnaire that they used to survey undergraduates at the University of Missouri, approximately 30 percent of female students reported restricting calories to “save them” for alcohol consumption. 

Though the conclusions from the original study did not consider the psychological effects of the “Freshman 15,” Lombardi said that the phenomenon may be a backlash to the publicity of Freshman 15, which gained traction up to a decade ago in the popular media. However, a 2011 paper published by researchers at Ohio State University found that college freshman only gain an average of 2.4 pounds for women and 3.4 pounds for men. 

Both Lombardi and Beck-Ellsworth agree that the profile for individuals with eating disorders is not nearly as narrow as formerly believed.

“It’s not just young, Caucasian girls that are affected by eating disorders,” Beck-Ellsworth said. “It can affect anyone.”

Surprisingly, studies have shown one demographic of college-aged individuals in particular to be heavily impacted by eating disorders. In 1999, a study published in the International Journal of Eating Disorders found that in a pool of 1,445 student athletes, 9.2 percent of women were diagnosed with bulimia and 10.85 percent were seen to engage in binge eating on a weekly basis. Although there is no hard and fast rule requiring it, the weight of female athletes are not listed on any NCAA roster across any sport. 

Recently, eating disorders have received more attention from the medical and academic communities. But both Beck-Ellsworth and Lombardi agree that more needs to be done. Beck-Ellsworth noted that in spite of a 10 percent mortality rate amongst the diagnosed, medical professionals still don’t have formal training in handling eating disorders. 

“I think the biggest thing that needs to change is an increase in awareness,” Beck-Ellsworth said. “People need to be aware that this is something that can affect everybody. It’s important not to just immediately rule someone out because of their appearance.” 

James Holmes’ psychiatrist warned he may pose threat

University of Colorado-Denver psychiatrist Dr. Lynne Fenton told a campus police officer about her concerns June 12, the day after she met with Holmes for their only session. Her fears were revealed Thursday when the new judge presiding over the case unsealed a host of search warrants and arrest documents.

Fenton also told Lynn Whitten, a campus police officer, that after she stopped seeing Holmes he “threatened and harassed her via email/text messages,” the documents said.

Whitten deactivated Holmes’ ID so he could not get into university classrooms and laboratories, the documents say. That appeared to contradict what university officials have said: that Holmes was not banned from the university because of a threat but because his ID was deactivated as part of the normal student withdrawal process.

It was unclear whether Aurora police knew of Holmes’ threats before they interviewed Whitten on July 21, the day after the mass shooting. Holmes, now 25, is accused of opening fire during a premiere of the latest Batman movie, “The Dark Knight Rises.”

The once-promising neuroscience doctoral student at the university is charged with 166 counts of first-degree murder, attempted murder and weapons charges. He had flunked an oral exam in early June, began withdrawing from the university June 10 and met with Fenton on June 11.

Details about the case have been tightly sealed from the earliest days of the investigation. Yet on Thursday, District Judge Carlos A. Samour Jr. reversed previous rulings on public access and made public the arrest affidavit and 12 search warrants.

Samour took over from Chief Judge William Sylvester on Monday after Dist. Atty. George Brauchler of Colorado’s 18th Judicial District announced he would seek the death penalty.

Sylvester withdrew because of the time constraints that come with a capital punishment trial, which would leave him little time for administrative duties. Holmes’ trial, initially scheduled to begin Aug. 5, has been pushed back to February at the earliest.

Holmes’ attorneys are widely expected to use an insanity defense. They had offered a guilty plea in return for a life sentence without possibility of parole.

The newly unsealed documents give glimpses not only into the early hours of the investigation but into Holmes himself. A search warrant for his apartment — which had been booby-trapped, presumably to kill anyone who entered — revealed a student’s life that seemed at once mundane and bent on destruction.

Along with chemicals used for explosives, rounds of ammunition, pistol cases and paper targets, police seized movie posters, video games, apartment lease papers, numerous computers, 48 containers of beer and other liquor and stacks of school textbooks. They found prescription medication for sertraline, a generic version of Zoloft used to treat depression, panic disorder and obsessive-compulsive disorder; and Clonazepam, usually prescribed to treat anxiety and panic attacks.

And they found a Batman mask, the documents say.

Much of the information in the documents had come out at Holmes’ preliminary hearing in January. Moviegoers at the Aurora theater on July 20 told police they saw a man who fit Holmes’ description sit in the first row but then leave through the emergency exit before the movie started. At 12:38 a.m., an assailant burst through the emergency door, threw a canister of tear gas and began shooting.

Police have said records show Holmes went on a shopping spree that started in May, amassing semiautomatic weapons, large quantities of ammunition, military-style gear, chemicals that could be used for explosives and tear gas canisters.

The documents also shed some light on a notebook that Holmes mailed to Fenton, which was found in a university mail room after the shooting. The notebook was described in search warrants as brown with a placard on the cover that said “James Holmes.” Also written on the outside of the notebook were the words, “My Life.”

Police said “it appeared to be a journal,” but the writings were “unknown.” Tucked into the notebook were twenty $20 bills that had been burned. There was a sticky note on the outside with an infinity symbol on it.

The notebook, which is still sealed, has been a bitterly contested issue. The prosecution says it should be admitted into evidence, but the defense says it is part of doctor-patient privileged communication.

Next week the judge will continue to hear arguments on whether a FoxNews.com reporter will have to divulge her law enforcement sources who told her about the contents of the notebook despite a gag order.

nation@latimes.com

Everyday Heroes: Royce White and Anxiety

Everyday Heroes: Royce White and AnxietyHouston Rockets rookie Royce White is a star in more ways than one. White says he is like everyone else. He enjoys going to the movies and listening to music. He was the No. 16 pick in the 2012 NBA draft, and that is extraordinary. He also suffers from obsessive-compulsive disorder, generalized anxiety disorder, and some phobias (fear of heights and fear of flying).

A few months ago, he was under scrutiny for standing up to the Rockets’ lawyers and officials. He requested that his anxiety issues be treated the way other players’ physical illnesses and injuries are treated. For instance, NBA players are expected to fly frequently to cities where their games are played. White’s anxiety disorders makes it so that sometimes he is unable to do so. He requested to be able to travel by bus, and if he is delayed he doesn’t want to be fined the same amount as players who miss practice because they overslept.

Both parties struggled to reach a resolution, but after many discussions and meetings, the Rockets and White were able to reach a compromise in some areas. He was reassigned to the Houston Rockets’ D-league team, the Rio Grande Valley Vipers.

White’s story is of interest to many who are afflicted by mental illness. He is not in denial of his challenges, but he is not being quiet about it either. He has taken on the cause to help decrease the stigma society continues to place on mental health issues.

The Anxiety and Depression Association of America reports that there are “40 million American adults who suffer from anxiety disorders and only one-third of those suffering from an anxiety disorder receive treatment.” Anxiety itself has found its way into everyday language by many who experience stress. Yet, there are still many people who have no idea that anxiety disorders can be paralyzing and should not be trivialized.

Many individuals are embarrassed about their illness because they fear discrimination or that it’ll be a stumbling block in their careers or jobs. White has taken the risk and has decided that his basketball career is important, but becoming a “poster child” to decrease the stigma is more significant.

If you personally are struggling with mental illness or have a loved one who is, how are you handling it?

  • Acknowledge it.

    Mental illness does not discriminate against race, gender, age, religion, or economic status. However, many sufferers may be in denial because they believe that asking for help, taking medication, or seeking therapy is a sign of weakness and irresponsibility. They don’t want to admit they have a problem and will only accept help when their normal functioning has deteriorated significantly, and they can no longer afford to suffer alone.People in prominent positions may be embarrassed to admit they have a mental illness. I’m not necessarily talking about movie stars or other celebrities. I am referring to individuals who have been able to succeed in life despite their mental adversities. They need to speak up to help normalize the disrespect many still receive due to their mental ailments.

  • Speak up.

    When people share their struggles, others will become aware and even be surprised that their friend, boss, best friend’s daughter or spouse also is experiencing emotional and mental pain. Successful men and women with a mental illness can be an example to society and can contribute to the idea that a mental disorder does not define the person. The media seem to highlight the negative situations and many sufferers feel embarrassed and despondent. Thus, they choose to continue their silence.

  • Connect with others.

    A dear friend has found that when he shares the challenge of having a son with mental health struggles, others connect emotionally with him. They trust him and are able to share their own journey with him. Your story of having been there may make a difference to someone who is feeling hopeless.

Society needs to understand that a person can be “normal” and still have mental health challenges.

Royce White is a hero. We need more heroes to stand up and speak up for mental health. Depression and ADHD are becoming more accepted as those in the limelight continue to talk about their experiences. Even people not in the public eye can tell our stories and help someone.

Will you be a hero for someone else? Take a stand. It will be worth it!


 

Scientifically Reviewed
    Last reviewed: By John M. Grohol, Psy.D. on 2 Apr 2013
    Published on PsychCentral.com. All rights reserved.

 

Girl Talk: My Husband’s Obsessive Compulsive Disorder Was A Living Nightmare




My husband was always a little strange — but that’s par for the course in a marriage sometimes. Sure, he covered his face whenever he encountered the smell of bleach, and he took to maniacal cleaning rather than use poisons to eradicate a cockroach problem. He demanded we turned off the heat at night to protect his lungs. I thought all of it was cute. It took me a while to realize that his unusual quirks were actually symptoms of a terrible disorder.

I met John* on Craigslist. We were looking for a third roommate and he was one of the many people we interviewed that hot August day. He had a dark, curly mop of hair and a full face with dimples, and he seemed nice. He was from South America, and had traveled all around the world; I found him extremely compelling. We interviewed a few other people that day but felt that we connected the most strongly with John, so we asked him to be part of our household.

When he later moved out, we stayed in touch intermittently. It was April, the year after he moved out, when he contacted me again. We began spending lots of time together after that. We went out together. He took me shopping and helped me nail a work presentation. I was surprised to feel how I was falling for him, considering I didn’t necessarily feel attracted to him while we were living together. We finally made it official on a drizzly spring night. I was in love. We spoke about all of our previous issues as roommates and they all seemed to dissolve away. Soon after, I found out I was pregnant. Because we were in love, we decided that we wanted to marry right away. Things couldn’t have been better between us.

It took me a while to see the Obsessive Compulsive Disorder (OCD). OCD, as defined by the International Obsessive Compulsive Foundation, is a disorder of the brain and behavior which causes severe anxiety in those affected. It’s estimated that one in 100 people have the disorder, which means that somewhere between two and three million people are currently living with OCD. John’s symptoms began to emerge when we ordered a simple household test to be done. Because I was pregnant and we were living in an older building, we were concerned when we spotted some chipping paint. We wanted to get the apartment tested for lead, and after some wrangling with the landlord, she agreed to send a professional to have it tested. We were both dismayed when some rooms tested positive — and that’s when things began to unravel.

John’s disorder first emerged as a series of concessions he asked me to make for him. The first concession seemed perfectly reasonable. Otherwise, why would I have agreed to it? He asked me not to put magazines on the floor of the bathroom. See? No biggie. I agreed. Soon, though, one concession tumbled on top of the other, and I found myself buried in unreasonable requests.

It seemed that instead of being a normal couple planning for the rest of my pregnancy, our lives had now become committed to the prevention of accidental ingestion of lead. At this point, John was spending hours poring over the Internet, reading the most current research on this terrible toxin. According to his findings, it only took a piece of lead as big as a grain of salt to poison a child. Scary, I know. But with something that small, and invisible, how do you even begin to protect yourself from it? According to John, nothing short of extreme vigilance would do. He wanted to be sure we weren’t exposed to one errant piece of dust, and began to monitor my behavior everywhere in the apartment. My actions were being strictly controlled. Things started to get tense between us.

Soon, we ate, spoke and breathed lead. Okay, not literally, thank God, but something close to that. Since the bathroom had the highest levels of lead, anything brought in there needed to be wiped down after use. Any clothing that dropped on the floor anywhere in the apartment needed to be laundered immediately. It didn’t matter if it was only on the floor for a second, or my only clean outfit — it went straight into the laundry. I could have brought in dust from the bathroom which deposited itself on the floor in another room, he insisted. I’d have to wait in my pajamas until he could wash it. Only he could go to the laundromat since only he could follow proper procedure to get our clothes correctly cleaned.

After months of tension about all these things, and more, we decided the only solution was to move out. Our landlord offered to remediate our apartment, but he decided that whatever she wanted to do was going to put us in more danger and he refused. Money was tight, but he assured me he’d figure it out. The move, of course, necessitated that he did all the packing, which was the second major concession I made.  According to his findings, the only way we wouldn’t bring lead dust to the new apartment is if everything was dusted meticulously before we left. Being pretty sure that I had never done anything meticulously in my life, I agreed. It didn’t take me long to realize I had made a grave mistake.

It took John hours to pack each box. Although our bank account was cleaned out to make a security deposit, and I wasn’t working, he kept missing work anyway to keep packing. Our baby had now arrived and I was feeling especially protective, and became more and more alarmed. Since we didn’t have cash, moving expenses were covered with my credit card. A very pricey HEPA vacuum cleaner, a special filter for that, masks, special wipes, you name it, went on my credit card with neither of us having any idea when we were going to be able to pay it off. Desperate to be moved out by the date we agreed upon with the landlord, I purchased for him anything he said he needed. We had signed a special contract with her and wasn’t sure of the consequences if we broke it. I begged him to let me help and he wouldn’t budge. Something wasn’t right with this. Out of frustration I asked him to just throw whatever wasn’t packed out. “But, even if I’m throwing it out, I have to clean that too,” he said. “It’s not safe for me to handle otherwise.” I just yelled at him to do it. I never wanted to be in that apartment ever again.

Here’s the thing: John is an intelligent man. He must have a plan, I thought. I told myself we’d figure something out. Thankfully, the new apartment we’d selected was in perfect condition. We had made it. I was happy. We stared out the window at our new view and kissed passionately. But it didn’t take long for my husband to find hazards in the new apartment. Soon, I wasn’t allowed to walk by the windows of the apartment. I also was banned from the laundry room — all laundry had to be done by him. Months went by like this. He refused to unpack the few boxes we brought with us. Although still financially vulnerable due to all the work he missed, I found myself replacing the things in the boxes with our limited funds. Most of our things had been thrown out, and the promised money from the job he got wasn’t materializing. I realized this wasn’t a quirk, or something funny or interesting about his personality at all. It was a full blown disorder. And although he clearly had Obsessive Compulsive Disorder, he refused to get diagnosed, let alone treated. I was besides myself in frustration.

After months of feeling controlled and isolated from my friends, my tolerance level was low. It took one phone conversation to send me over the edge. That day, I had looked in the mirror that day to see how a new shirt I bought looked on me. He called, and when I told him what I was doing over the phone he started to scream. Why was I in the bathroom, what was I doing in there, he screamed. I had no clue I wasn’t allowed in my own bathroom. This was after a week of brutal fighting, and it seemed he had no limits as far as how he would treat me? I was concerned about how my son would be affected if he continued to see Daddy screaming at Mommy like that. I had made enough concessions for him, and this was one I could not make. So, on a sunny fall day I did the most difficult thing I had ever done in my life. I packed my bags and walked out on someone I loved.

It was later that day when he realized I had left. Drama ensued, of course, and we spent many hours speaking about my feelings over the phone. We talked about his disorder, and how I wanted him to get treatment for it. He refused. Naturally, he was extremely upset, but I refused to budge. I lived with my parents for several months, but eventually living in a small, rural town away from my friends and the city I’d known, began to wear on me.

And there was a bigger issue. Despite our problems, I still loved John. He cared about our baby more than anything, and wanted our son to be close to him. Things stabilized for us financially. Despite continued misgivings about how he treated me, I decided to move back in. Things still aren’t perfect, but we’re both trying. I have a dream, though, that despite all this, there will be a time when we can walk through our beautiful city unencumbered by our fears, without worrying about lead. Until that day happens, we are going to therapy, and I will continue to work on my patience. As a friend so wisely said, “With love there is hope.” So I’m continuing to hold onto that hope.

*Name changed to protect identity.

Pets/Bernhard Pukay: Stressed-out cat’s hair loss could have other causes

Question: My older female cat, Cinder, has suddenly lost all the hair on her tummy and the insides of her hind legs. We also have two male cats that are now about two years old and have been living with us since they were about six weeks old. Last fall they started challenging Cinder and chasing her around the house, which she does not like. She ends up trying to hide from them and growls if they come near her. This has been very upsetting for my husband and I because at times it sounds like a serious cat fight although it is all vocal. Could this stress be responsible for Cinder’s hair loss?

Answer: Absolutely. Some cats will lick themselves excessively as a form of obsessive-compulsive disorder (OCD) in much the same way that people bite their fingernails or mutilate themselves when stressed or troubled. In veterinary medicine the term psychogenic alopecia is used to describe this condition. It is usually due to some form of stress, whether anxiety, boredom, or some radical change in surroundings. In all probability, in the case of Cinder, the likely cause is stress caused by the conflict between her and the two males cats.

Cats can react to stress in several ways, such as by adapting to the stress, marking their territory with urine, or grooming themselves excessively, The excessive grooming can lead to hair loss and skin damage, primarily because a cat’s tongue is very rough and too much licking can quickly lead to self-excoriation. The tummy and insides of the hind legs are the most commonly targeted sites for excessive grooming although all four legs can be involved, as can any part of the body.

There are many other medical reasons for overgrooming, including fungal and bacterial infections, skin parasites, and even systemic illness. An especially common cause is allergies, especially food allergies, which can lead to a condition called eosinophilic granuloma complex. This condition can manifest itself precisely in the way that you have described. For this reason, it is a good idea to have your veterinarian examine Cinder to see what the cause is.

If, as you and I suspect, your veterinarian determines that the problem is indeed psychogenic, he or she will work with you to correct the underlying problem, or will prescribe medication (e.g. amitriptyline) to correct the behaviour. There is also a commercially available product called Feliway that has been shown to be effective in reducing the incidence of OCD due to stress in some cats. It is available as a spray or as a wall “plug-in�. It works by releasing a pheromone that reduces anxiety and stress.

Dr. Bernhard Pukay is an Ottawa veterinarian. Address letters to Pet Care, Ottawa Citizen, P.O. Box 5020, Ottawa K2C 3M4. Email: pets@ ottawacitizen.com. Due to the volume of mail, not all letters can be answered.

Man ruled unfit to stand trial in slaying of three people

By VANESSA REMMERS

CHESTERFIELD – A Dinwiddie County man accused of killing two Chesterfield women and suspected of killing his father was deemed mentally incompetent to stand trial Friday.

Herbert Bland Jr., 23, had to be guided by court officers when he appeared binded in handcuffs before a judge in Chesterfield General District Court. Bland’s rolling, blank gaze fell across those in the courtroom before officers nudged him toward the judge’s bench.

Bland did not answer any questions and swayed slightly as the judge decided to continue his case until July 10, during which time doctors will attempt to restore his mental competency.

“You need to cooperate with your doctors who are going to help you,” the Hon. James J. O’Connell III said. “And you need to keep in touch with John Rockecharlie [Bland’s defense attorney] who is going to help you.”

Bland will reappear in court July 10 for mental reassessment. If doctors are not able to restore his mental competency by that time, the judge may continue the case for another 90 days.

Bland’s court-appointed defense attorney John Rockecharlie said that he would not be surprised if the case is continued for six to nine months.

“I have dealt with people who are trying to fake it, and those that are not. He is definitely not faking it,” Rockecharlie said.

The judge based his decision on a court-ordered psychiatric evaluation that took place not long after Bland was charged for fatally shooting Elizabeth Fassett, 42, and her mother, Barbara Fassett, 65.

That evaluation, performed by court-appointed forensic psychiatrist Dr. Evan Nelson, found that Bland was mentally incompetent. Nelson based his findings on whether the defendant could understand the charges against him and whether he could help his defense attorney defend him.

“It is just clear that he is not connected to reality,” Rockecharlie said of his attempt to talk with his client.

Doctors from Central State Hospital will visit Bland at Riverside Regional Jail. They will likely give Bland a diagnosis, Rockecharlie said.

Police believe Bland killed the two Chesterfield women earlier in the afternoon of Jan. 7 before making the 20-minute drive back to his Dinwiddie home. An encounter with his father in that residence ended with the son shot in the chest and the father, Herbert Bland Sr., dead.

A UPS worker delivering a package to the Fassett home in the 5200 block of River Road in Chesterfield discovered the bodies of the two women later in the afternoon. Police believe Bland had been romantically involved with Elizabeth Fassett in the past.

Dinwiddie deputies were alerted to the Bland residence in the 2000 block of Harris Drive by Herbert Bland Sr. The father believed his son had taken his gun and used it in a shooting, according to court records.

When a deputy arrived at the scene, Bland Jr. stumbled outside the residence holding two pistols. He told authorities that his father had shot him and that he shot his father in the head, according to court records.

The killings came four months after the younger Bland completed two years of court-ordered psychiatric treatment. That court order stemmed from an August 2010 incident where the younger Bland was accused of physically assaulting his parents, court records show.

Dr. Walid Fawaz of the Virginia South Psychiatric Family Services placed the younger Bland on a variety of medications including Haldol, an anti-psychotic drug, Paxil, which is used to treat obsessive-compulsive disorder, anxiety and depression, and Risperdal, which is mainly used to treat schizophrenia.

Court records show that Bland Jr. attended all of the appointments and complied with the medications. He continued to live with his parents and was unemployed.

“He is doing a little better and does not feel paranoid … does still feel that people can control him,” Dr. Fawaz wrote in a progress report. “He has had no suicidal or homicidal ideas.”

The 2010 case was dismissed in September 2012, once Bland’s treatment was completed.

Charges against Bland in connection to the death of his father are still pending. Dinwiddie Commonwealth’s Attorney Lisa Caruso has said that she is waiting as Bland progresses through the Chesterfield court system.

– Vanessa Remmers may be reached at 804-722-5155 or vremmers@progress-index.com

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Obsessive-compulsive disorder is a serious illness that society has made fashionable, says an Otago University psychologist.

The newfound “popularity” of OCD had led to people “pulling out the textbook and ticking their symptoms off”, according to senior lecturer Chris Gale, who specialises in anxiety disorders.

“The Americans are in the habit of diagnosing everything and everyone, but we don’t actually need to medicate everything.”

He said it was of growing concern that people made light of OCD and compared a few individual quirks to a debilitating illness that can stop people functioning.

“The key thing to measure is the threshold for treatment, and to actually have a disorder it has to be making your life a misery.”

The Phobic Trust, which supports and treats people with anxiety disorders, was also concerned about how “loosely” some people used the illness to describe their own behaviours.

“It’s important that people with certain traits, such as liking things clean or ordered, are not necessarily confused with people who genuinely suffer from OCD,” a spokeswoman said.

Those at the extreme end had their day-to-day lives constantly interrupted. “For those who have severe OCD, it would be very hard to hold down a job or just function in life.

“Leaving the house and getting things done would be extremely difficult.”

For some OCD sufferers, their illness carried a real stigma that made it difficult to confide in friends and family.

“Some of the people we see are very secretive about it and, although we encourage them to tell their family, many choose not to disclose it,” she said.

Psychologists have yet to find middle ground on an approp- riate threshold for treating and medicating OCD, from which about 3 per cent of the population suffers.

OCD is an anxiety disorder causing unwanted and repeated thoughts, feelings, ideas, sensations, obsessions or behaviours that make the sufferer feel driven to do certain things.

“Sometimes it might be an experience that triggered it but for others it’s brain wiring,” the spokeswoman said.

“There are also cases where there is a genetic predisposition, and more than one person in the family has it.”

OCD ON SCREEN

 

  • Tony Shalhoub as Monk in the American detective series of the same name.
  • Jack Nicholson as Melvin Udall in the movie As Good As it Gets.
  • Leonardo DiCaprio as Howard Hughes in The Aviator.
  • Nicolas Cage as Roy Waller in Matchstick Men.
  • Jack Lemmon as Felix Unger in The Odd Couple.
  • Leonardo DiCaprio says he has to stop himself from letting it take over his life.
  • Billy Bob Thornton is versed in repetitive compulsive actions, and has a phobia of antique furniture.
  • Charles Darwin showed classic signs of suffering from OCD.
  • David Beckham is obsessed with symmetry and hates odd numbers.
  • Michelangelo is believed to have had it.


 

– © Fairfax NZ News



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