This is a great presentation/speech. I hope you can watch and share it! It really needs to go viral! Hopefully the correct video will play. It is a TED talk about mental illness and community.
Surviving
Suicide
2013, Addiction, Alcohol, Alcoholics, Anorexia, Bipolar, Borderline Personality, BPD, Bulimia, Bullying, Compulsive Eating, Compulsive Exercising, Counselor, Dead, death, Depression, Dyke, end of world, Fag, Fat, Fat Hatred, Gay, GBLT, gender, Homo, Homophobia, Homosexual, Hope, insanity, Lesbian, Lithium, Lunatic, Mania, Manic, Manic-Depressive, Mental Health, Mental Illness, ocd, Panic Attacks, Pansexual, Paranoid Schizophrenia, Problems, Psych Meds, Psycho, Psychosis, Queer, Schizophrenia, self-care, Self-Harm, Self-Injury, Sleep Disorders, Suicide, Support System, Surviving, Trannie, Trans
Schizophrenia and Negative Symptoms: Q&A with Dr. Potkin
2013, Abilify, affective flattening, alogia, Anti-anxiety meds, Anti-depressants, Anti-psychotics, asociality, avolition, Biology, Bipolar, Brain, Depakote, Depression, dopamine hypothesis, Dr. Steven G. Potkin, drugs, Education, Genentech, Geodon, Haldol, Haldol DEC, Haldol Decanoate, Health, insanity, Irvine (UCI), Kristin Bell, Lithium, Mania, Manic, Medicine, Mental Health, Mental Illness, Mood Stabilizers, N-methyl-D-aspartate, NAMI, negative symptoms, neuron, neuroscience, neurotransmitters, NMDA, NMDA receptor hypofunction hypothesis, Paranoid Schizophrenia, Paxil, Prescription Meds, Psych Meds, Psychiatrist, Psychiatry, Psychiatry Denial, Psycho, Psychoactive Substances, psychoanalysis, Psychology, Psychosis, Risperdal, schizoaffective disorder, Schizophrenia, Science, Seroquel, stigma, Support System, Surviving, symptoms, synapse, sz, Therapist, Trazadone, treatment, treatment-resistant, Trilifon, Wellbutrin, Zoloft, Zyprexa
I have some great news! I was able to ask Dr. Steven G. Potkin, Professor of Psychiatry in the Department of Psychiatry and Human Behavior at the University of California, Irvine (UCI) Medical Center, some questions regarding the negative symptoms of schizophrenia. He is also the Robert R. Sprague Endowed Chair in Brain Imaging. It was a brief, by email interview, but I’m happy to share what I’ve learned with you all! The following is the Q&A:
Kristin: What are negative symptoms?
Dr. Potkin: “Negative” does not refer to a person’s attitude, but instead to a lack of characteristics that should be present. Symptoms include reduced amount and content of speech, even when encouraged to interact (alogia), lack of emotional and facial expression (affective flattening), diminished ability to begin and sustain activities (avolition), decreased ability to find pleasure in everyday life (anhedonia) and social withdrawal (asociality). [1] [2]
Negative symptoms can appear a few years before other symptoms appear in young adulthood in the so-called “prodromal” stage of the illness.[3] Unfortunately these symptoms often go undetected because they manifest themselves as issues common among teenagers: social withdrawal, problems with school work, irritability, depression and sleeping problems.[4]
Kristin: Do all people with schizophrenia have negative symptoms?
Dr. Potkin: No, but at any point in time, negative symptoms can affect approximately 50 percent or more of people with schizophrenia.[5] [6]
Kristin: How do negative symptoms affect a person with schizophrenia? How do they affect their family and friends?
Dr. Potkin: Research suggests that for people living with schizophrenia, negative symptoms are key factors in poor quality of life as well as problems with personal hygiene, school and work performance, maintaining relationships, interacting within the community, and participating in social activities. [7] [8] [9] [10]
For caregivers of people with schizophrenia, negative symptoms may cause more burden than do other types of symptoms as they see their loved ones life isolated and lacking in meaning or joy. [11]
Kristin: How are negative symptoms currently treated?
Dr. Potkin: Current treatments for schizophrenia focus on reducing characteristic symptoms and can include both medication and psychosocial interventions.[12] No effective medication treatment has yet been approved for specific treatment of negative symptoms. Despite progress in the medication side of treatment, there are still unmet needs in terms of symptom control. A large study found that despite treatment, approximately 57 percent of people receiving treatment for a schizophrenia spectrum disorder still had at least one negative symptom.[10]
Kristin: What is the research that Genentech is doing regarding negative symptoms?
Dr. Potkin: Researchers at Genentech are pursuing new treatment strategies for schizophrenia, including increasing N-methyl-D-aspartate (NMDA) receptor activity in the brain in order to target the mechanism that may be a common link between the positive, negative and cognitive symptoms of the disorder.[7] [9] [11] [12]
Specifically, through a clinical trial program, Genentech is looking at an investigational medication for people with schizophrenia, including people who experience mostly negative symptoms of schizophrenia, despite taking medication. For more information, please visit www.SearchLyteschizophrenia.com
Kristin: How can family and friends of someone with schizophrenia help someone with negative symptoms?
Dr. Potkin: Caregivers can talk to doctors about interventions including medication, psychosocial rehabilitation (work, school, relationships), medical care and wellness, and therapy (e.g. cognitive behavioral therapy and peer support groups), as well as ongoing clinical trials.[13] They can work with physicians to find the medications and non-medicine therapies that are right for their loved one. Different medicines may have different side effects. Caregivers can also consider programs from the National Alliance on Mental Illness (NAMI) including:
• NAMI Hearts and Minds
– Online, interactive wellness initiative
• NAMI Peer-to-Peer
– Free, 9-week educational course on recovery
• NAMI Connection
– Recovery support group for adults
Kristin: Do scientists know the biological mechanisms involved in negative symptoms? If so, what are the areas of the brain and/or mechanisms involved in negative symptoms?
Dr. Potkin: In the 1970s, the “dopamine hypothesis” of schizophrenia emerged, suggesting the biological basis of schizophrenia was an excess of signaling by dopamine, a chemical messenger in the brain. This theory, however, could not explain negative or cognitive symptoms.[6] In the late 1980’s a newer theory suggested positive, negative and cognitive symptoms could all be due to reduced function of NMDA receptors in the brain. This theory is now known as the “NMDA receptor hypofunction hypothesis.”[6] [7] [8] [9]
Researchers are pursuing new treatment strategies for schizophrenia, including increasing NMDA receptor function in the brain in order to target the mechanism that may be a common link between the positive, negative and cognitive symptoms of the disorder.[7] [9] [11] [12] It is thought that NMDA receptor activity is an important pathway in psychiatric disorders, especially schizophrenia.
End of article.
*Note: I would like to thank Dr. Potkin for helping me put together this interview. This research is very exciting and I hope that negative symptoms can be tackled in this decade! I know how debilitating they can be!
______________________________
1. Gard DE, Kring AM, Gard MG, Horan WP, Green MF. Anhedonia in schizophrenia: distinctions between anticipatory and consummatory pleasure. Schizophr Res. Jul 2007;93(1-3):253-260.
2. Strauss GP, Gold JM. A new perspective on anhedonia in schizophrenia. Am J Psychiatry. Apr 2012;169(4):364-373.
3. Stahl SM. Stahl’s Essential Psychopharacology: Neuroscientific Basis and Practical Applications. 3rd ed. New York: Cambridge University Press; 2008.
4. National Institute of Mental Health. Schizophrenia. 2009; http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml. Accessed July 7, 2012.
5. Kirkpatrick B, Fenton WS, Carpenter WT, Jr., Marder SR. The NIMH-MATRICS consensus statement on negative symptoms. Schizophr Bull. Apr 2006;32(2):214-219.
6. Bobes J, Arango C, Garcia-Garcia M, Rejas J. Prevalence of negative symptoms in outpatients with schizophrenia spectrum disorders treated with antipsychotics in routine clinical practice: findings from the CLAMORS study. J Clin Psychiatry. Mar 2010;71(3):280-286.
7. Ho BC, Nopoulos P, Flaum M, Arndt S, Andreasen NC. Two-year outcome in first-episode schizophrenia: predictive value of symptoms for quality of life. Am J Psychiatry. Sep 1998;155(9):1196-1201.
8. Kirkpatrick B, Fenton WS, Carpenter WT, Jr., Marder SR. The NIMH-MATRICS consensus statement on negative symptoms. Schizophr Bull. Apr 2006;32(2):214-219.
9. Kurtz MM. Symptoms versus neurocognitive skills as correlates of everyday functioning in severe mental illness. Expert Rev Neurother. Jan 2006;6(1):47-56.
10. Milev P, Ho BC, Arndt S, Andreasen NC. Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudinal first-episode study with 7-year follow-up. Am J Psychiatry. Mar 2005;162(3):495-506.
11. Provencher HL, Mueser KT. Positive and negative symptom behaviors and caregiver burden in the relatives of persons with schizophrenia. Schizophr Res. Jul 25 1997;26(1):71-80.
12. National Institute of Mental Health. Schizophrenia. 2009; http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml. Accessed July 7, 2012.
13. National Institute of Mental Health. Schizophrenia. 2009; http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml. Accessed July 7, 2012.
Shootings, Shootings Everywhere!
2012, Clackamas Town Center, Connecticut, controversial, Crime, crimes, Culture of Violence, Denial, Discrimination, gunman, Guns, insanity, Kristin Bell, Las Vegas, Lunatic, Male, Men, Mental Health, Mental Illness, OR, Oregon, Paranoid Schizophrenia, Portland, Psych Meds, Psychiatrist, Psychiatry, Psychiatry Denial, Psycho, Psychology, Psychosis, schizoaffective disorder, Schizophrenia, school, shooting, Shopping, Suicide, Support System, Surviving, USA, ViolenceIn the United States in the past week we have been shocked and devastated by public shootings. First in Oregon at Clackamas Town Center, then in Connecticut at an elementary school and then in Las Vegas at a hotel. Most people, myself included, are horrified at the violence. Naturally, we now all seem to be debating about how to prevent these senseless acts. Some people latch onto gun control, some people latch onto our violently oriented culture, and some people latch onto mental illness as an issue. I honestly don’t know that there are any answers or actions that society can make as a whole to prevent things like this happening in the future, but this bit of rant is not about answers exactly. What I want to talk about is what is NOT the answer.
What is NOT the answer is scapegoating any one group of people. From my perspective as a person living with mental illness, I am (of course) sensitive to people ranting about how the mentally ill should be locked up or about how all of the shooters must have been mentally ill. Honestly, we don’t know enough about the situations or people to comment. What I have to say time and time again is that statistics bear out the fact that mentally ill people are generally not violent and are, in fact, more likely to be the victims of violent crime than the perpetrators of violent crime. People with mental illness are often more of a threat to themselves than to anyone else. Even if all of the shooters turn out to be mentally ill, that does not mean that all people with mental illness are violent. We can note also that all of the shooters were male, but that doesn’t mean that all men are violent and that all men should be locked away from society or have their rights stripped.
It is distressing to me that so often the conversation will turn into attacks on mentally ill people aka “the crazies” and how to keep them away from “the rest of us.” There are literally millions (or more) people living with mental illness who never harm anyone. If someone is violent AND mentally ill, that does not mean they are violent BECAUSE they are mentally ill. They are violent, because they are violent. We should focus our energies on how to make the world a less violent one with people who are less violent, not perpetuate stereotypes and attack other humans who have done nothing wrong.
New Abstract Art by Me + Discussion
abstract art, Art, art journal, Autobiography, Bipolar, Borderline Personality, BPD, DBT, Depression, drawings, EDNOS, Handmade, Hope, Illustrated, insanity, iPad, iPad Art, journal, Kristin Bell, Marsha Linehan, Memory, Mental Health, Mental Illness, Mindfulness, pain, Painting, Photography, process, Prozac, Psych Meds, Psychiatrist, Psychiatry, Psychiatry Denial, Psychoactive Substances, Psychology, Sculpture, Self-Harm, Self-Injury, sketchbook, Stress, Suicide, Support System, SurvivingProcess:
I was reading a book by Marsha Linehan, the creator of Dialectical Behavior Therapy treatment for people with Borderline Personality Disorder, and I was struck by the theoretical concepts that she was discussing in the book. At the same time, I had been thinking about my friend who has BPD. I thought about the unending pain she suffers and how there is so much rage and turmoil in her life. I wanted to incorporate both Linehan’s concepts and aspects of my friend into the art journal that I just started working on as a collaboration with my friend, John.
So, John began the journal by preparing many pages and providing inspirations and prompts, then he mailed it to me and it was my turn to lay down something on the pages.
The first thing I did was use a handheld scanning pen to scan vertical snippets of text from the Linehan book. I then printed out the scans and cut them up into various pieces. You can just make out some of the text, like the words “dysfunction” and “BPD” and “DBT” if you look closely at the first piece.
Next, I began by glueing down the various text scans onto the journal…all over the top of what my friend John had already done. You can see bits of the yellow wash that he had laid down already. I added handwritten elements with text that expressed how I felt about my friend with BPD. Some are “rage and flounder,” “escape impossible,” “improbable at best,” and “hermedically sealed” (which I spelled wrong, but ends up being seen as “medically sealed” in the final product which I think is just as good and apt).
I colored over parts with a reddish pen, because for me, reddish colors always seem to represent pain and suffering, if not outright blood. I also used my label maker to add “A FACE TO YOUR PAIN,” because I felt like this was my way of giving her pain a face. There is also a scrunched up scribble of a face contorted with pain on the journal page just above the label. Then I started adding layers of cut out graph paper, because I wanted part of the image to have some linear and quantifiable aspects, like the discreet squares of red in contrast to the smudgy blob of red elsewhere. I also added a cut out plastic sleeve that I applied color to.
I then decided that I wanted to cut out some of the page and expose the treatment that was done on the other side of the page by my friend John. I likened this to an escape hatch to relieve the immense pressure and pain of the page and my friend’s actual pain. I cut out “hermedically sealed,” which is how it seems my friend’s pain is stored, and I pasted it onto the next page so that it could be seen as “medically sealed” through the cutout. A lot of my friend’s history involves intense and traumatic encounters with the medical establishment, so I thought this was appropriate. I cut out and folded over some of the page to make more linear elements and to add to the color use on the page as well. I also wanted to do this to incorporate the idea of overlapping aspects of our lives and our histories.
When I cut out “hermedically sealed” it left an opening that for me seemed like a window and represents the hope I still have for my friend despite what seems like endless suffering. I painted the page that can be seen underneath with blues and greens to represent the sky and grass, and I placed a puffy Hello Kitty sticker in the window as a kind of whimsical “hello” with friendship. Part of the other cutout seemed organic and flower-like to me, so I also added a stem of a flower for more aspects of light and living, but also change and death. With some of the folded over cutouts I felt like there was too much color and light, so I blacked out the spaces with a magnum black Sharpie.
Throughout the process, I was concerned not only with symbolic aspects of representation, but also with the aesthetic elements of line, color, space, balance, etc. So, part of the experiment was definitely symbolic, but I also spent time adjusting the image elements to try to make an interesting and unifying picture.
When I felt like I was done with the journal page, I took a photograph of it and posted it to Facebook to keep track of the process aspect of the journaling project. I was then compelled to go further with the image by enlarging parts of the image and cropping them in interesting ways. I took snapshots of the screen with my iPad and then emailed them to my desktop machine where I processed them in Photoshop and then printed them out. I really didn’t know how they would look printed out or if I would use or like them at that point.
I liked how the prints looked, but I felt they really should be juxtaposed somehow, so I combined them.
The closeup crops that I made were deliberate. I based my decisions on aesthetics and also on what words would be incorporated into the image. “A FACE TO YOUR PAIN” was cropped into “TO YOUR PAIN” for one image and “OUR PAIN” for another image. I wanted to bring together these two aspects of the experience of pain, the self and the other, and comment on the interaction between the two. For my friend who suffers, it seems that her pain is hers alone and that it is an isolated state of suffering, but she also has friends, family and care providers who care about her and interact with her pain and suffering. We, of course, have our own pain and suffering, but seeing her in pain is also difficult and informs our own pain and our own worldview.
When I combined the crop prints, I was “mindful” of the tension between the different images on the page and wanted to incorporate Linehan’s ideas about thesis, antithesis and synthesis in the overall picture. For me, the synthesis is the final completed work, but up until then I felt that I was going back and forth trying to find the finished piece. I felt that I needed to bridge the piece to make it more cohesive, so I added a red ribbon that tied the gaps that I saw together, also tying my friend to the world and people outside of herself. I then added sculpted copper wire to put back in a bit of the organic that I thought was lost and to act as a core and a crowning jewel.
For the second image, I employed much the same process. I printed out crops of the journal and then cut and fit the pieces together like a puzzle. For me, the second piece is more about hope, so I used the “A Window Opens” text in part of it and the overall image is less dark and red. The border of the image is a handwritten excerpt from Linehan’s text that talks about dialectics and how it is a process that persuades and encourages movement. I used the red yarn to imply some movement, but also tension. The yarn is tight, but not so tight that it tears the page. It also helps to unify the image I think, adding that aspect of synthesis.
The journal page.
The first finished piece.
The second finished piece.
Review: Loud In the House of Myself by Stacy Pershall
Acceptance, Anorexia, Anti-anxiety meds, Anti-depressants, Anti-psychotics, Anxiety, Ativan, Autobiography, Binge Eating, Bipolar, Black & White, Body, Body Image, Books, Borderline Personality, Bulimia, Compulsive Eating, Compulsive Exercising, Depakote, Depression, Eating Disorders, EDNOS, insanity, Internet, Kristin Bell, Lithium, Loud In the House of Myself, Mania, Manic, Manic-Depressive, MAO Inhibitors, memoir, Mental Health, Mental Illness, Mood Stabilizers, Navane, Prozac, Psych Meds, Psychiatrist, Psychiatry, Psychoactive Substances, Psychology, Reading, Review, Self-Harm, Self-Injury, Stacy Pershall, Stories, strange girl, Suicide, Surviving, Thin, Weightloss
Loud In the House of Myself: Memoir of a Strange Girl is a new book by Stacy Pershall. Of course, I was immediately drawn to this memoir, because it is a) a memoir b) about a “strange girl” and c) deals with mental illness. Yay! Since I’m undoubtably a strange mentally ill girl, I knew I had to read this. Pershall writes about her life growing up in Arkansas and her morphing from an über-sensitive child into a teenager and young adult with Borderline and Bipolar issues. Anyone familiar with the mental illness memoir genre will certainly have heard of Elizabeth Wurtzel, and I just bring her up, because UNLIKE Wurtzel, Pershall is not whiny in her writing! Pershall is matter-of-fact about her trials and symptoms, even though the reader can imagine the actual playing out of illness to be much more harsh and unbearable.
Pershall describes her unrelenting eating disorder, mood swings and suicide attempts with a steady and precise hand. This book seems really accessible to me, because Pershall speaks not only to those of us who have been through the mental health care system, but also to people who might not really understand this special weirdness. The only thing I would like to see more of in this book is more OF this book! haha. Seriously though, I enjoyed reading this memoir and would love to read more from Pershall. I would especially recommend this book to people struggling with Borderline Personality Disorder. There is a special misery only known by Borderlines that is never really represented in the books that ostensibly deal with Borderline Personality Disorder. I really wish there were more accounts like this that show the uncrazy through the crazy of Borderline Personality Disorder.
President Obama: It Gets Better
Acceptance, Activism, Allies, American, American History, Bisexual, Bullying, Children, Dan Savage, Depression, Discrimination, Dyke, Fag, Friends, Gay, GBLT, Hate, Homo, Homophobia, Homosexual, Hope, Kristin Bell, Lesbian, obama, Pansexual, Protest, Queer, Same Sex, Self-Harm, Self-Injury, Straight, Suicide, Support System, Surviving, Trannie, Trans, Video, ViolenceIt Gets Better…
Acceptance, Activism, Allies, Bisexual, Bullying, Cool, Dan Savage, Depression, Discrimination, Dyke, Equality, Fag, Friends, Gay, GBLT, Hate, Homo, Homophobia, Homosexual, Hope, Kids, Kristin Bell, Lesbian, Mental Health, Protest, Queer, Same Sex, Savage Love, Self-Harm, Self-Injury, Shame, Suicide, Support System, Surviving, The Stranger, Trannie, Trans, ViolenceSuicide
Acceptance, Alcoholics, Anti-depressants, Anxiety, Ativan, Bipolar, Counselor, Cry, Dead, Depression, Fat Hatred, GBLT, Kristin Bell, Manic-Depressive, Mental Health, Mental Illness, Mood Stabilizers, Panic Attacks, Psych Meds, Psychiatry, Schizophrenia, Self-Injury, Suicide, Support System, Surviving, Xanex, ZoloftI’m just going to say it: GOD DAMN DEPRESSION!!! It is so horrible that words cannot describe it, right? You know what I am saying. And, at this moment, I have no idea how many people out there are thinking about or attempting suicide. It is the great loss, the tragic loss…every suicide. I’ve tried wrapping my head around it. Tried thinking of it as someone’s way out of pain, but the truth is, each attempt, every moment spent toiling over it: TRAGIC.
I know that it feels like the only way to relieve the pain. Looking back on my own suicidal ideation and attempts, I can only wonder: WHAT WAS I THINKING!?! Okay, I know what I was thinking…tired. tired of being tired. tired of having this huge pain that I couldn’t really describe, this unending sorrow swallowing me whole. Tired of being a failure, and broke, and stupid, ugly, horrible, disgusting, friendless, and every other bad thing I could think to call myself. But, I don’t know, mostly I didn’t even care if I lived or died. These few pills will take away the pain? Okay, I’ll be dead and it won’t matter anymore. My big dillema was getting rid of my body without horrifying other people.
Notes on Schizophrenia: Probability/Social Aspects
Allies, Anti-depressants, Anti-psychotics, Friends, Haldol, Kristin Bell, Mental Health, Mental Illness, Problems, Psychiatry, Schizophrenia, Surviving, ViolenceSo, schizophrenia sounds like a really friggin’ scary deal, and, it kind of is, but the odds are that you probably will not develop it. Interestingly enough, schizophrenia effects about 1 percent of the population worldwide according to most statistics. There also seems to be little variation to the 1 percent figure. In other words, developing and developed countries seem to have the same rates of illness. It seems that there is not one place that has more or less of the disease.
Here are some other figures provided by narsad.org,
kristinbell.org 