“Psychiatrists have long thought that depression causes insomnia,” wrote the New York Times editorial board this weekend, “but new research suggests that insomnia can actually precede and contribute to causing depression.”
Small studies have shown that cognitive behavioral therapy for insomnia (CBT-I) can be of serious benefit to people with depression. “If the results [of this research] hold up in other studies already underway at major medical centers,” they write, “this could be the most dramatic advance in treating depression in decades.“
That really is a substantial assertion.
… I [had] quit drinking and drugs. I’d surrounded myself with good healthy people who were doing the same. I was eating healthy. I was exercising. I was going to therapy and genuinely striving to live my life in a kind manner. I wasn’t harboring any secrets that were weighing me down. In essence, I was doing everything one could reasonably expect me to do to “feel good.” But I didn’t feel good at all. I didn’t sleep. I shit only fiery liquid. Brushing my teeth made me puke. My whole body ached.
After seeing a psychiatrist and starting to take an SSRI:
… Gradually, I did begin to feel better. After a while I could brush my teeth without vomiting. My poops began to firm up and exit my butt as horrible solids rather than horrible liquid. After a couple of weeks, I noticed a familiar feistiness in my trousers, and when I addressed it, the amount of semen I produced was around 700 gallons. (I’m estimating.) Most wonderful of all, though: I could sleep again. I didn’t wake up at 11:15 after having been asleep for 45 minutes and lie in bed terrified for seven hours. I began to interact with other people more at work and socially. I asked women on dates and sometimes they said yes.
For Delaney the ability to sleep was more gratifying than the return of his libido. If you’re a fan of his work, you know that is a substantial claim. When I read it my first reaction was, how many of those symptoms were downstream of the part about not sleeping?
Insomnia and depression very often go chicken and egg. The bodily and psychological symptoms of each can be indistinguishably brutal. Not eating, not moving, not relating to people; it all coalesces in a flushing symptom-toilet. The idea is that CBT-I can sort of stop the spinning. That’s especially promising because behavioral therapy is empowering for patients, can be inexpensive, and involves no medications. A new antidepressant medication can be enough of a variable by itself. The basics of CBT-I, which has been effectively administered to patients in these studies by students in four sessions (which won’t always be the case), involves teaching basic elements of sleep hygiene:
Don’t do anything in bed except sleep and sex. Don’t have a clock by your bed such that the numbers and ticking are embedded in your mind. Don’t drink alcohol right before bed. More sleep isn’t necessarily better. (Hypersomnolence and sleeping at odd hours is maybe just as stereotypical of the depressed person as is insomnia). Optimal sleep hygiene involves the same, typical amount of sleep every night. Don’t sleep in just because you can. Likewise, don’t go to sleep early. Make it the same seven or eight-hour block every night. Don’t try to compensate for sleep loss. Keep a record of your sleep habits. (Never someone else’s; always yours.)
Sometimes therapists will also counsel people about healthy perspectives on sleep, how to overcome “self-defeating assumptions” like: “Without an adequate night’s sleep, I can hardly function the next day,” or “Medication is probably the only solution to sleeplessness.”
Expect to hear more about focusing on sleep treatment in depression treatment.
LEBANON—A failed suicide attempt by a Sunapee man claimed the lives of a young couple and their unborn child in a crash on Interstate 89 on Saturday, according to the Attorney General’s Office.
Robert Dellinger, 53, of Sunapee, was arraigned in Lebanon District Court Wednesday afternoon on two counts of manslaughter and has been ordered held on $200,000 cash-only bail.
According to Senior Assistant District Attorney Susan Morrell, Dellinger left his Sunapee home Saturday afternoon after an argument with his wife over his depression medication and a bedtime curfew imposed by his doctor, and headed south on Interstate 89 in his 2005 Chevy pickup.
In an attempt to commit suicide, Morrell said, Dellinger then crossed into the median, went airborne into the northbound side of 89 and sheered the roof off the car driven by Amanda Murphy and hit a sign post before coming to rest on the side of the road.
Murphy, 24, who was eight months’ pregnant, and her fiance, Jason Timmons, 29, were killed. Dellinger suffered non-life-threatening injuries and was treated at Dartmouth-Hitchcock Medical Center.
After his release, Dellinger was arrested and charged with two counts of homicide. Via video from Grafton County Jail Wednesday, Dellinger waived arraignment. Morrell argued that Dellinger, whom she said has considerable financial resources, should be held on $250,000 cash bail. Dellinger’s attorney, Peter Decato, argued to lower the bail to $100,000 cash only, but said that his client had already given him $250,000 to cover bail.
Judge Albert Cirone ordered bail set at $200,000, with conditions that Dellinger wear an electronic monitoring bracelet and undergo a psychiatric evaluation.
By Lucy Piper, Senior medwireNews Reporter
Shared genetic factors affect the risk for bipolar disorder and alcohol use disorder (AUD), suggesting a common underlying biology, research shows.
The risk for bipolar disorder was also significantly genetically associated with anxiety disorders, but the latter did not explain all of the genetic relationship between bipolar disorder and AUD.
The researchers, led by David Glahn (Olin Neuropsychiatry Research Center, Hartford, Connecticut, USA), suggest: “Searching for the common genetic influences for bipolar disorder and AUD combined, rather than focusing on each illness separately, may provide insight into psychopathology.
“Thus, it is possible that biomarkers sensitive to risk for both illnesses could be identified, which in turn could be used to refine our diagnostic nosology.”
They also point out that sharing common genetic factors is in line with observations that bipolar disorder and addictive disorders share similar brain networks and the possibility of overlapping neurophysiologic mechanisms.
“Our findings suggest that common genes may influence these putatively shared neural processes,” the team writes in European Psychiatry.
The team examined 733 Costa Rican individuals who were the first, second and third degree relatives of 61 sibling pairs with bipolar disorder. Overall, 32% met criteria for broad bipolar phenotype, 17% had a lifetime AUD diagnosis, 32% met criteria for lifetime nicotine dependence, and 21% had an anxiety disorder.
Twenty-eight percent of patients meeting the criteria for bipolar disorder also had an AUD, a significant over-representation compared with 19% of those without bipolar disorder.
In bivariate analysis, bipolar disorder was significantly phenotypically correlated with AUD, nicotine dependence, and anxiety disorder and the team reports that these phenotypic correlations were largely driven by genetic rather than environmental factors.
The researchers estimate that 47–57% of the genetic variance predisposing individuals to bipolar disorder also influences the risk for AUD.
The genetic correlation between AUD and nicotine dependence suggested a single genetic pathway and even when the genetic influence of anxiety disorders was considered in the bivariate model, the genetic correlation between bipolar disorder and AUD remained significant.
“These findings improve our understanding of the shared genetic factors underlying these illnesses and could enhance the development of novel approaches to improve illness course, response to treatment, and treatment adherence,” Glahn et al conclude.
Licensed from medwireNews with permission from Springer Healthcare Ltd. ©Springer Healthcare Ltd. All rights reserved. Neither of these parties endorse or recommend any commercial products, services, or equipment.
The boy just needs a good spanking.
Daniel needs a proper male role model.
You’re a bad mother.
Stephanie has heard it all. Her mother, three sisters and brother abandoned her when Daniel was first diagnosed. They didn’t believe Stephanie. There had to be another reason for his behavior.
Friends told her, please, don’t talk about mental illness around the children. But word leaked out. Kids taunted Daniel.
Hey, stupid! You’re mental!
Once, Daniel was beaten by an acquaintance while a friend shot video that was later posted on YouTube. It showed Daniel getting punched in the face, then falling to the ground and being kicked.
Some friends shunned Daniel and his mom. The phrase “mental illness” was met with fear, disbelief, prejudice, ignorance.
Stephanie herself had not understood the early signs. At age 6, Daniel complained he heard voices. She downplayed it. She told herself the walls were paper thin, that he was hearing conversations throughout the home.
Then, everything changed.
On a fishing trip one weekend in March 2009, Stephanie watched as Daniel pushed their lunch supplies, one by one, off the top of a picnic table. Chips, cups, napkins. When she scolded him, he apologized: I’m sorry. I’m just clumsy.
He kept the real reason to himself: Voices urged him to shove his 3-year-old brother into the lake so he would drown. Daniel pushed stuff off the table instead; it was his way of deflecting the voices, of keeping his brother safe.
At school the following Monday, Daniel’s hallucinations intensified. He stabbed himself in the head with a pencil because he was having more thoughts about hurting his brother. Finally, he confided in his teacher. Only then did his mother learn the truth.
Mom, I have been having thoughts of wanting to hurt my brother, he told her, but don’t worry, I don’t want to harm him.
Stephanie shifted into overdrive. She stayed home to monitor Daniel’s behavior. She began trying to get him admitted to a hospital for evaluation. It took five days but she succeeded. On March 25, 2009, she went with him to Southwest Mental Health Center.
“I had never seen anything like I did that night,” Stephanie recalls.
Daniel’s mood changed every second. He was happy, sitting next to his mother. Then, suddenly, he was under a table, clinging to a leg and crying. He ran around the room, announced he could fly. Then he stopped and looked at his mother: Mom, did you know I can see through doors?
To Daniel, all of it was real.
“Patient reports he started hearing voices within the last week that he describes as multiple voices, mainly telling him to hurt his brother and specifically to stab him with a sharp object,” the hospital evaluation said. “Also telling him to hurt self. Prevents acting on these commands by hurting self or doing things with other objects.”
Daniel was hospitalized for two weeks. His diagnosis: type 1 bipolar disorder, compounded by episodes of psychosis.
Daniel takes five different medications to try to regulate his mood swings. Among the pills is lithium for his bipolar disorder.
Stephanie went to Barnes Noble and bought nearly every book they had on bipolar disorder. She learned to understand what she had witnessed. Daniel’s impulsive urges, his sudden bursts of energy fit the description of mania; his extreme lows matched the depression that accompanies bipolar disorder. The voices and visions her son described met the definition for psychosis.
Stephanie also grappled with something the hospital report hinted at: Guilt that her recent divorce from Daniel’s stepfather had scarred a boy who’d never known his own father.
Daniel suffered from a lack of self-esteem, and he was “likely to feel he lacks control and things happen to him,” the report said. “This could be influenced by the early ‘loss’ of his biological father and more recently the reported relational loss with his stepfather.”
Stephanie renewed the pledge she’d made to her son on the day he was born. “Daniel will never know how heartbreaking it was to watch him spiral up and down in a matter of seconds,” she wrote in her journal, “but he will know that no matter how hard it gets, I will always be there to pick him up.”
Her son understood for the first time that he suffered from mental illness. “I can tell you how I felt,” Daniel says. “I was really, really scared.”
That year, Stephanie took the summer off to spend time with her boys. She bonded with them over fishing. “I was the only mom out there,” she says. The other boys all had their fathers in tow. Stephanie brags: “We caught more fish than anyone else.”
But by year’s end, Daniel was in the hospital again. His episodes changed with every medication regimen. Drug combinations that were meant to control his state of mind seemed only to make his condition worse.
The frequency of hospitalizations soon picked up.
The year 2010 was marked by four, and in 2011 there were five, including a 90-day court-ordered commitment.
That was one of the toughest for Stephanie. The doctor suggested that route because outpatient therapy wasn’t working.
Agreeing to a court commitment meant a loss of control. He’d be away for three months minimum.
In a way, she felt relief. Her son was where he needed to be, getting professional care, and she had time to breathe. She recalibrated and devised a long-term plan for Daniel. She taught a class for medical assistants at a local trade school and continued working full-time.
But she couldn’t help but wonder: Am I doing the right thing?
She visited Daniel every day for the first two weeks. She fretted the staff would deem her a bad mother if she didn’t show up.
But the visits were awful. Daniel hurled insults at her, said he hated her. Once, he threw a chair at her during a family session. He accused her of wanting to get rid of him. Every time, she left the hospital more miserable than when she entered. “I dreaded going there instead of being happy to see him.”
She dubbed the stroll from the hospital to her car in the parking lot “the walk of shame.”
It didn’t help that her siblings weren’t supporting her. They thought she exaggerated Daniel’s problems. Initially, so did Jose.They met at the trade school, where Jose was teaching, too. Stephanie told him up front about her son’s illness.
If you want to run, she said, go right ahead.
They’ve been together two years now.
When a child suffers from an “invisible” illness, Jose says, “You just have a hard time accepting that there’s something wrong.”
“Once I understood better,” he says, “that’s when it got easier.”
But he adds, “I don’t think everyone can do it.”
Jose runs his own air conditioning business and can rush home when needed. He has filled a void in Daniel’s life. The first hospitalization occurred exactly one year after Daniel’s stepfather left. And every year since, that anniversary has triggered an episode resulting in hospitalization.
It’s taken time to build trust, but Daniel now calls Jose “Dad.”
Not only has Jose not turned and run, but he embraces the messy life of raising a teenager, one who happens to be mentally ill. Many people, he says, don’t view those with mental illness as human; they’re freaks, crazies, even monsters. Other people, Jose says, have this Hollywood vision of mental illness: It’s difficult but then — ta-da — everything is fine.
“The reality is people have to live with it for a lifetime,” he says. “The illness doesn’t end when the credits roll. If you don’t have the resolve or the stamina to handle it, you’re in a lot of trouble.”
In real life, the script gets ripped up.
Beverly Hills, CA, Dec. 11, 2013 (GLOBE NEWSWIRE) — Menopause
Symptoms of menopause often begin well before the onset of
Some of the most common menopause symptoms include hot flashes and
Depression can be a complex condition. Both physical and emotional
Supplements can also be extremely helpful. Supplements can be used
DON’T PAUSE is an all-natural herbal supplement that has been Press Release by http://www.avitalweb.com
depression, menopause lightheadedness,
tingling, menopause headaches and
other menopause symptoms can significantly affect a woman’s life
before, during and after menopause. Natural supplements can provide
women with the critical support they need during what is often a
physically and emotionally difficult time of changes. Natural
supplements can be particularly helpful for women who are suffering
from menopause-related depression. Dr. Shoreh Ershadi
menopause. The ovaries begin to adjust and decrease hormone
production as eggs stop being released every month. Periods can
become irregular along with ovulation, and women may notice a
marked increase or change in premenstrual symptoms.
night sweats. However, many women also experience mood swings,
headaches, joint pain, increased cholesterol levels and decreased
bone mass. In fact, Dr. Shoreh Ershadi, president and CEO of the
AntiAging Institute of California, has identified 45 different
symptoms of menopause, including depression.
factors can play a role in its development. Women who have
depression may find that lifestyle changes can be enough to
alleviate it. These lifestyle changes should include a healthier
diet, moderate exercise and healthy sleep habits. Women may also
find benefit in therapy or programs that help them manage their
stress or environmental situations that could be triggering or
worsening their depression symptoms.
to address some of the underlying physical reasons for depression.
They can help restore healthy sleep patterns, boost energy levels,
decrease mental fog and reduce anxiety. The right supplement can
also help restore hormone levels, which is often enough to decrease
designed to reduce menopause-related depression. It has ingredients
that can help balance hormones and provide relief from the
discomfort of depression. The AntiAging Institute of California
offers a wide selection of natural and herbal products that can
help people live healthier lives naturally, including DON’T
Beverly Hills, CA, Dec. 11, 2013 (GLOBE NEWSWIRE) — Menopause
Symptoms of menopause often begin well before the onset of
Some of the most common menopause symptoms include hot flashes and
Depression can be a complex condition. Both physical and emotional
Supplements can also be extremely helpful. Supplements can be used
DON’T PAUSE is an all-natural herbal supplement that has been
Press Release by http://www.avitalweb.com
An associate professor of finance at the University of Indianapolis believes Indianapolis-based Eli Lilly and Co. will be leaner moving forward. Matt Will says Lilly has been cutting expenses in preparation for Wednesday’s U.S. patent expiration of its depression medication Cymbalta, which accounted for 22 percent of revenue last year. He says the company hopes decreasing payroll expenses and beefing up research and development will help offset an “obvious” drop in future revenue. Lilly hopes to launch multiple drugs next year, including diabetes and cancer treatments. Will believes the company “will not be the same Lilly” in five years.
More Schools Suing IRS Over ACA
Two dozen Hoosier school corporations have joined 15 others in a lawsuit against the U.S. Internal Revenue Service. The filing involves part of the Affordable Care Act which would impose financial penalties on employers that do not offer health insurance to those working more than 30 hours per week.
Lake City Bank Builds on Fort Wayne Growth
The president of Warsaw-based Lake City Bank believes the plan to open a branch in a $71 million downtown Fort Wayne development is “a natural extension” of the company’s growth in the market. David Findlay says Lake City already has more deposits in Allen County than other Indiana-based banks. The company is planning an office in the new Ash Brokerage Corp. headquarters.
Organization Accepting Cook Cup Nominations
Indiana Landmarks is seeking nominations for a statewide prize honoring historic structure restoration. The organization will award the Cook Cup in April.
Allegion Rings Opening Bell
Executives from Ireland-based Allegion PLC rang the opening bell this morning on the New York Stock Exchange. The company is a spinoff from Ingersoll-Rand PLC (NYSE: IR) and has its U.S. headquarters in Carmel.
Former State Rep Starts Public Affairs Company
A former state representative has launched a public affairs company in southwest Indiana. Sally Rideout is behind Rideout Public Affairs. She was elected to the Indiana House in 1994 and has also served as a vice president with the Chamber of Commerce of Southwest Indiana.
Regency Announces Louisiana Acquisition
Evansville-based Regency Properties has acquired a shopping center in Louisiana. The company says the deal for the 128,000 square-foot property in DeRidder adds to its focus on county seat communities. Regency now has properties in 10 states.
Peoplelink Announces Deal For Texas Company
South Bend-based Peoplelink Staffing Solutions has acquired MEP Inc. of Dallas, Texas. The deal gives the Indiana company a larger presence in cities including Dallas, Austin and Phoenix. It also expands Peoplelink’s construction trades brand.
Eskenazi Health Up And Running
The transformation of Wishard Health to Eskenazi Health in Indianapolis continues. The Eskenazi Health Outpatient Care Center started caring for patients today, following Saturday’s transfer of patients from the old Wishard Hospital to the new Sidney Lois Eskenazi Hospital.
Purdue Series Highlights Rural Areas
Purdue University researchers are trying to help state leaders address needs in rural communities. A series of publications focusing on quality-of-life issues is being released through the university’s extension office. The research focuses on how population and other changes are potentially shaping the future of rural Indiana.
Project Lead The Way Supporting Coding Effort
Indianapolis-based Project Lead The Way Inc. is participating in a national initiative designed to boost interest in computer sciences. As part of Computer Science Education Week which begins today, the science, technology, engineering and math curriculum provider will take part in Code.org’s “Hour of Code” event.
For more Inside Indiana Business, visit www.insideindianabusiness.com.
When Andy Behrman was diagnosed with bipolar disorder over 20 years ago, he didn’t know anyone who had the illness. He didn’t even know what it was. “I remember asking the doctor if I needed to have an MRI and if I would live to see my next birthday.”
For about 10 years he struggled with stabilizing his disorder, which included being misdiagnosed by seven mental health practitioners, taking over 40 medications and receiving ECT. It’s a period he chronicles in his book Electroboy: A Memoir of Mania.
One of the biggest lessons he’s learned in managing his bipolar disorder and living a successful life is to embrace the illness.
“I’ve chosen to be friends with my bipolar disorder instead of [viewing it as] the enemy. I feel [that] too much emphasis is placed on ‘fighting’ mental illness and ‘recovery,’ when I know today that learning to embrace my bipolar disorder and keeping the focus on coping and managing to live with it on a daily basis would have been a much better strategy.”
Bipolar disorder is a difficult and complex illness. It affects all areas of a person’s life and often requires meticulous management.
Still, it can help to know how others with the same illness have coped. Below, individuals with bipolar disorder share what they’ve learned in managing their illness.
“The biggest lesson I’ve learned is to take bipolar disorder very seriously,” said Julie A. Fast, a bestselling author of books on bipolar disorder and professional coach who works with loved ones of people with the illness. Fast was diagnosed with rapid cycling bipolar disorder II in 1995.
“It’s not like other illnesses. It’s sneaky and dangerous if you don’t watch it all of the time.” She compared it to type I diabetes. “People with diabetes one can’t mess around – ever. I can’t either.”
Fast follows her treatment plan and practices self-care. And despite the challenges, she describes herself as an eternal optimist. “As long as I can keep relatively stable, I always find a way to get on with life and strive for happiness. I will never stop.”
Having a Great Support System
“I’ve learned the most important thing in managing my bipolar disorder is my support system,” said Elaina J. Martin, who’s written a memoir about living with mental illness and pens the Psych Central blog Being Beautifully Bipolar.
This includes her psychiatrist, therapist, mom, best friends and boyfriend. “I recently found a great new psychiatrist who takes time to explain things to me and we decide together on changes to my medication. I have a therapist that I trust and together we come up with solutions to things that are troubling me.”
She can call her loved ones at any time, day or night, if she needs them. “My boyfriend is my live-in supporter.” Her support system also helps her recognize when she might be experiencing a depressive or manic episode.
Martin also has learned that some people simply won’t stick around. It’s been a hard lesson, but it’s also been important to let them go. “You deserve to surround yourself with people who support you and care about your wellness.”
Kevin Hines, author of the critically acclaimed memoir Cracked, Not Broken: Surviving and Thriving After a Suicide Attempt, has developed a vast support system of family and friends. “I call them my ‘personal protectors.’ They stay close in my life so that when I cannot be self-aware with my accepted mental illness they can catch me when I inevitably fall.”
Committing to a Treatment Plan
“The biggest lessons I’ve learned in managing my illness is that I need to commit to my treatment plan and take care of myself to stay well for my family,” said Jennifer Marshall, who writes the blog BipolarMomLife.com, which explores what it’s like to open up about living with mental illness.
It was a realization she made after her last hospitalization. Marshall was hospitalized twice in the beginning of her illness and two more times during the years she had her kids.
“All four times were because I was unmedicated. Once I came to the realization that bipolar disorder is an illness I’ll live with for the rest of my life, I pledged my dedication to my treatment plan.” In addition to medication, her plan includes getting enough sleep, exercise and regular visits with her psychiatrist and therapist.
Martin also has accepted that she needs to take medication to manage her illness. “I am neither ashamed nor embarrassed by that need.” For her sleep is paramount, as well. “Lack of sleep can fling me into mania so I am sure to get at least eight hours a night, usually more.”
Forney has come up with small ways to make treatment more tolerable. She keeps her medication clearly labeled in a Peanuts lunchbox. After getting her blood drawn (she takes lithium), she treats herself to a fancy tea drink. It’s a tiny treat that makes her happy.
“The biggest lessons I’ve learned in managing my bipolar disorder is to be honest with myself and my psychiatrist,” said Laura SQ, who was diagnosed with bipolar disorder in 2002 and proudly lives a stable life in Houston, Texas, with her family. “Without honesty, and without self-awareness I truly can’t maintain my stability.”
Hines, also a Global Mental Health Suicide Prevention Speaker, has bipolar I with psychotic features. For him being completely honest about his symptoms, especially the distorted, psychotic beliefs, is a key part of recovery. “When I have paranoid delusions and hallucinations, I am able to voice them to those closest to me, and thus they are able to squash those mind distortions with their ‘true reality.’”
Being Kind to Yourself
“I also know, and have learned, I cannot be too hard on myself. We must give ourselves the room needed to grow with love, understanding and patience,” SQ said.
Even though being self-compassionate might not be easy (or natural), Forney reminds herself that self-flagellation is useless. She likened her self-berating to a parent yelling at a child who’s having a tantrum. Rather than calming them down, the parent just keeps yelling, and the child keeps getting upset.
Taking A Holistic Approach
“In my personal experience with bipolar disorder, I learned that in addition to my medications and counseling guidance, I needed to incorporate a holistic approach to my self-care,” said Gail Van Kanegan, DNP, RN, a nurse practitioner at Mayo Clinic in Rochester, Minn.
She practices yoga, tai chi and meridian energy exercises, which have improved her sleep, boosted her energy and enhanced her self-confidence.
Having A Routine
For veteran journalist and Psych Central managing editor Candy Czernicki, the biggest lesson has been the importance of following a strict schedule. Interpersonal and Social Rhythm Therapy is valuable for helping people with bipolar disorder create and adhere to daily routines.
The Power of Stability
When Forney was diagnosed she feared that treating her bipolar disorder would kill her creativity. She associated creativity with the electrifying passion of mania. Today, with treatment, she feels just as passionate about her work, just in a “more grounded way.”
She compared it to falling in love. At first couples have a highly charged, head-over-heels attraction. Over the years, this develops into a deeper and calmer way of being passionate with each other, she said. “Stability is good for my creativity.”
For Behrman, now a mental health advocate and speaker, overcoming the most difficult challenges of his life has given him perspective and made him a better person.
“Because I have successfully navigated myself through this devastating experience, which on several occasions could easily have taken my life, every challenge in front of me seems so much easier today.” Today, his coping skills are finely tuned, and he’s become a more strategic thinker, a better father and more empathetic friend.
Hines views his illness as one of life’s greatest gifts. “Had I not developed it and gone through such pain, I would not be the man I am today. I would not have been given the opportunity to share my life with so many others. My voice has been and will continue to be heard.” His story continues to inspire people all over the world and change lives for the better.
“Stability is a growing and learning process every day,” SQ said. She encouraged readers to never give up. “I won’t say it will be easy. I will say, it will be worth it.”
Margarita Tartakovsky, M.S. is an Associate Editor at Psych Central and blogs regularly about eating and self-image issues on her own blog, Weightless.
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ST. PAUL, Minn. (AP) — Minnesota’s local jails are badly overburdened by mentally ill inmates who don’t have access to the kind of treatment they need, law enforcement officials said Tuesday.
The state Senate’s Judiciary Committee held a hearing Tuesday on mental health issues facing both the state Corrections Department and County Jails. State Sen. Barb Goodwin, who chaired the hearing, said Minnesota, many other U.S. states and the federal government have “dropped the ball” in providing consistent mental health care for the indigent.
“We’re hoping to figure out what kind of services we need to turn this around,” said Goodwin, DFL-Columbia Heights. “Right now I’m hearing from jails and prisons that 30 to 50 percent of inmates have a mental illness. And 30 to 40 years ago it was 5 percent. So the problem is increasing.”
Indeed, Hennepin County Sheriff Rich Stanek estimated that 25 to 30 percent of inmates in Hennepin County — the state’s largest county jail system — are suffering from some form of mental illness at any given time. It’s a risk both to the inmates and the employees who interact with them, he said.
“Often, jail staff must operate as front line mental health workers, and it’s a challenge to them day in day out,” Stanek said. “The jail is not the best place for someone with a mental illness. They should be receiving psychiatric care in a state facility.”
Two years ago, the Legislature passed a law that any jail inmate committed to a psychiatric facility must be transferred within 48 hours of the commitment ruling. But overburdened courts often aren’t able to actually hold commitment hearings on a timely basis, which is leaving mentally ill inmates stuck in jails anyway, officials said.
Sue Abderholden, the executive director of Minnesota’s chapter of the National Alliance for the Mentally Ill, said the problem largely stems from dwindling state resources for treatment programs. Such programs have often been among the first cut in lean budget times because the people being treated are on society’s margins and lack political influence, Abderholden said.
Abderholden ticked off a long list of programs and policy changes that she said would reduce the problem: mental health training for law enforcement and correctional officers, mental health courts, allowing inmates to continue psychotropic medication in jails, better state oversight of mental health care in jails, more housing options and other transition programs for mentally ill people coming out of jails are among a long list of what she said would be meaningful changes.
Goodwin said it’s a problem that’s likely to need a number of years to address properly. She said she would introduce a bill in the 2014 session that would at least start to tackle the issue.
“I’m bound and determined to do something,” Goodwin said.
(© Copyright 2013 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)
Maternal symptoms of anxiety and depression increased the risk of emotional and disruptive problem behaviors in children as early as 18 months of age, according to new research findings from the TOPP study. The risk persisted into adolescence and also gave an increased risk of depressive symptoms. The study is published in the Journal of Developmental and Behavioral Pediatrics.
“The findings emphasize the importance of health professionals spotting mental health problems in the mother and/or the child as early as possible, for example when the child attends their regular health check-ups at the health clinic in the early years,” says Wendy Nilsen, head of the TOPP study at the Norwegian Institute of Public Health. She is also the lead author of the paper, which is a part of her doctoral thesis from 2012.
Nilsen points out that the health clinic is a meeting point for over 95 per cent of all Norwegian families with young children.
“This gives health professionals a unique opportunity to introduce early preventive measures against the development of mental health problems,” says Nilsen.
Results from the study
- When the mother reported high levels of anxiety and depression symptoms early in the children’s lives, the children had a higher risk of emotional and disruptive problem behaviors during their childhood. In addition, the children had a higher risk of reporting depressive symptoms during adolescence.
- The association between maternal and later child problem behaviors was already present when the children were 18 months old.
- Disruptive and emotional problems and behaviors in the children were not affected by the mothers’ mental health.
- The researchers found that there was a tendency for disruptive problem behaviors to be a risk factor for later emotional problems, but not vice versa.
- Boys and girls were generally similar with regards to these findings. However, the researchers reported a tendency for problem behaviors in early school age (8.5 years) to be associated with later problems in adolescence for girls, but not for boys.
Paternal mental health in relation to child health is not examined in this study but has been examined in the TOPP-study at later time points.
Importance of early prevention
The results support former findings that also highlight early prevention and intervention.
“This is particularly important when the mother has reported high anxiety and depressive symptoms in the child’s first two years of life. These children had a higher risk of more depressive symptoms in adolescence. Problem behaviors in early life were also associated with later problems in adolescence,” says Nilsen.
The study also highlights the importance of research that follows children and their families from early childhood to adolescence.
“In this way we can gain knowledge about early traits of children and families that increase the likelihood of later mental health problems. This is important knowledge,” says Nilsen.
About the study
The data are from the TOPP study. The researchers wanted to examine whether and how maternal mental health and children’s disruptive and emotional problems affected each other. They also wanted to examine how these factors from childhood to early adolescence were associated with the adolescents’ self-reported depressive symptoms during adolescence and whether there were gender differences.
The study uses Norwegian mothers’ self-reports of their own mental health and their children’s problem behaviors (both disruptive and emotional) at five different ages from early childhood (18 months) to early adolescence (12.5 years). Questionnaire data from the adolescents are from 14.5 years and 16.5 years old.
As with other studies that follow families and their children over a longer period, some participants in the TOPP study have dropped out. It appears that the families who have participated in the later rounds have higher levels of education than those who have dropped out. The researchers point out that even though the findings of this study applies to most families, care must be taken when generalizing the results to those with the lowest educational levels. The researchers further state that it is possible that associations could be stronger and the levels of problems could be higher if these groups had been included.
About the TOPP-study
Through eight rounds of data collection, the TOPP study (“Tracking Opportunities and Problems in Childhood and Adolescence”) has collected questionnaire data about children and young people and their families. The study examines the pathways to well-being, good mental health and mental disorders in children, adolescents and their families.
Nilsen, W., Gustavson, K., Kjeldsen, A., Røysamb, E., Karevold, E. (2013). Pathways from maternal distress and child problem behavior to adolescent depressive symptoms — A prospective examination from 18 months to 17 years of age. Journal of Developmental and Behavioral Pediatrics, 35(5), 303-313
inurl:newsitem_dd.asp eli lilly cymbalta evista matt will university of indianapolis
The company’s osteoporosis drug Evista is set to lose patent protection in March 2014.
In October, Lilly outlined its plans to return to revenue growth. The company hopes to generate at least $20 billion in revenue and $3 billion in net income through 2014. The company announced a $700 million investment last month in its fight against global diabetes. The effort includes enhanced insulin production operations in Indianapolis, Puerto Rico, France and China.
Source: Inside INdiana Business
October 3, 2013
INDIANAPOLIS, Ind. – Eli Lilly and Company (NYSE:LLY) expects to launch several new medicines to treat unmet patient needs beginning next year, and return the company to revenue growth and expanding margins after 2014, senior executives told the investment community today at the company’s global research and corporate headquarters.
Lilly also reaffirmed its near-term goals of generating at least $20 billion in revenue, $3 billion in net income and $4 billion in operating cash flow through 2014, despite the impending loss of revenue due to patent expirations for two major products in the U.S., beginning in December of this year. The company also announced a new share repurchase program that will return an additional $5 billion to shareholders over time.
The upbeat outlook demonstrates that Lilly has been successfully executing its long-term innovation strategy to weather the significant impact of patent expiries from 2011-2014 and advance more medicines through late-stage development, approval and launch. The company’s strategy to focus on development of innovative medicines has produced the strongest pipeline in Lilly’s 137-year history, with 13 potential medicines in Phase 3, the final stage of clinical studies, or in regulatory review; and 26 more in Phase 2. This represents a total number in mid-to-late-stage development that is five times greater than the comparable total in 2004.
Launching several of those late-stage molecules will bring new medicines to patients and enable the company to return to revenue growth after 2014, John C. Lechleiter Ph.D., Lilly’s chairman, president and chief executive officer, told analysts gathered at the investment event.
“We’ve undertaken extensive efforts to transform our company to address the challenge of patent expirations and the demands of patients and payers for greater value from medicine,” Lechleiter said. “Today, we’re seeing our strategy bear fruit, backed by clinical data that strengthens our confidence in our innovation-based strategy and in our ability to return to growth. We’re determined to seize the tremendous opportunities before us and drive a new era of growth for Lilly and its shareholders, while delivering on our mission of improving the lives of patients.”
Specifically, Lilly executives noted several key events this year that demonstrate progress in the company’s innovation-based strategy:
U.S. and European regulatory submissions for two medicines to treat type 2 diabetes: empagliflozin (with partner Boehringer Ingelheim) and dulaglutide.
European submission of a new insulin glargine product to treat type 1 and type 2 diabetes.
U.S. and EU regulatory submissions completed for ramucirumab as a single-agent treatment for patients with advanced gastric cancer who have had disease progression after initial chemotherapy.
Second positive Phase III trial of ramucirumab in advanced gastric cancer, with the RAINBOW combination therapy trial demonstrating both improved overall survival and progression-free survival.
Positive results for necitumumab for patients with metastatic squamous non-small cell lung cancer, which could form the basis for a regulatory submission as early as 2014.
In 2014, the company believes it could launch empagliflozin, dulaglutide, and ramucirumab, subject to regulatory approval.
“Lilly has successfully replenished and advanced our pipeline to drive growth post-2014, while building a sustainable RD engine for the long-term,” said Jan M. Lundberg, Ph.D., executive vice president of science and technology and president of Lilly Research Laboratories. “We’ve filed for regulatory approval for an unprecedented number of investigational medicines this year with three in diabetes and one in oncology. In the future we expect to maintain a steady state of Phase 3 programs in the mid-to-high single digits, with a robust Phase 1 and Phase 2 pipeline to fill in behind.”
Lundberg noted that in the 2013 – 2014 timeframe, the company expects data readouts or pipeline advancements for nine of the assets in late-stage development. These include the three potential launches noted above, the regulatory submissions of necitumumab and the new insulin glargine product, and new data readouts for four other late-stage assets by the end of 2014. Lundberg also said the company anticipates seeing clinical readouts for the vast majority of its Phase 2 assets during this period.
Chief Financial Officer Derica Rice highlighted the company’s strategy to deliver on its financial goals through 2014 and grow revenue and expand margins post-2014.
“To prepare Lilly for 2014 and beyond, we committed to replenishing and advancing our pipeline, driving revenue in our growth engines and key marketed products, and increasing productivity and reducing our cost structure,” Rice said. “We’ve taken these commitments seriously and made substantial progress toward achieving our near-term goals, and we’re confident that this progress positions us for future success.”
Near-term business outlook (through 2014)
In the near-term, Rice said the company still expects to hit its financial goals in 2014, noting:
Selling, general and administrative expenses will decline as the company realizes the full benefit of the restructuring efforts in Europe and the U.S. sales organizations as well as savings from ending the direct-to-consumer promotion of Cymbalta.
The company will realize additional efficiencies in research and development and benefit from a substantial reduction in RD costs as the pipeline progresses through Phase 3 into regulatory submission.
Rice noted that market factors, including the devaluation of the Yen and slower market growth in key emerging market countries, have moderated the company’s near-term revenue growth expectations. These headwinds will make it challenging for the company to meet the minimum revenue goal of $20 billion in 2014, but Rice said the company is focused on finding appropriate ways to achieve this goal. Rice also said the company can and will take additional actions to achieve its 2014 net income and operating cash flow targets through reductions in operating expenses.
“Current consensus for 2014 is in-line with our net income goal, although we may get there in a different way,” Rice said. “For instance, current consensus may underestimate the impact of the Cymbalta and Evista patent expirations on our gross margin percent and our ability to reduce operating expenses, while it may overestimate our tax rate, which is trending in the low 20s percent. As usual, we’ll provide specific 2014 line-item guidance in January.”
Medium-term business outlook (post-2014)
Moving beyond 2014, Lilly expects continuing revenue growth in four of its five businesses: Diabetes, Oncology, Emerging Markets and Animal Health. The fifth, Bio-Medicines, loses U.S. marketing exclusivity on Cymbalta in 2013 and Evista in 2014, but is then expected to provide a large, stable and profitable revenue base moving ahead.
In Diabetes, Lilly expects continued growth for currently marketed products (insulins and Trajenta), with additional growth driven by the potential launches of empagliflozin, dulaglutide, the company’s insulin glargine product and its novel basal insulin.
In Oncology, Lilly has patents that could provide exclusivity for Alimta into the early 2020s in the U.S. and Europe, and sees significant growth opportunities from the potential launches of necitumumab and ramucirumab.
In Emerging Markets, the company sees continued strong underlying demand for pharmaceuticals in key Lilly therapeutic areas, led by Diabetes.
In Animal Health, strong global demand for animal-based protein and a growing companion animal market provide a strong platform for continued growth. Rice noted that the company intends to augment its strong organic growth in animal health with continued business development.
After the U.S. patent losses from Cymbalta and Evista, Rice said mid-term revenue in Bio-Medicines should be relatively stable, anchored by continued growth from Axiron, Cialis, Forteo, Strattera and Effient. Later in the decade, Bio-Medicines could provide significant revenue growth through a combination of launches of new molecules currently in Phase 3 development, including solanezumab, evacetrapib, baricitinib, ixekizumab, tabalumab and edivoxetine.
“With positive Phase 3 data on a number of assets, we’ve begun to de-risk our expectations for mid-term revenue growth,” Rice said. “I am confident in our outlook to return to a period of growth and expanding margins.”
Rice said the company still expects over time to lower SGA as a percent of revenue to the range of 28 percent to 30 percent and RD expense as a percent of revenue to a range of 18 percent to 20 percent. This would allow the company to achieve a total operating expense efficiency of approximately 50 percent of revenue by 2019, if not earlier.
Dividends and share repurchase
Lilly also reconfirmed today that it expects to maintain its dividend at least at its current level and announced that it will supplement its annual dividend of approximately $2 billion per year with share repurchases totaling $5 billion over time.
Webcast of Investment Community Meeting
A live webcast of the Lilly Investment Community meeting, along with presentation slides, is available through a link on Lilly’s website at www.lilly.com. The meeting will start today at 8:30 a.m. ET and last until approximately 12:30 p.m. The webcast will be available for replay over the next 12 months.
About Eli Lilly and Company
Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers – through medicines and information – for some of the world’s most urgent medical needs. Additional information about Lilly is available at www.lilly.com. C-LLY
Source: Eli Lilly and Co.
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