The Mood Disorders Support Group of New York City

	M O O D S
Newsletter of the Mood Disorders Support Group of New York City
April   2004	Table of Contents (all articles are on this page) Get the Most Out of a Group  by Li Lippman June Lecture: Stress and Mood Disorders  Ask the Doctors with Ivan Goldberg and Joe Nieder The Reader's Corner  Book Review by Betsy Naylor   The Best Awful by Carrie Fisher Limerick This by Howard Smith We Get By with a Little Help from Our Friends . . . Contact MDSG	When printed, this page will automatically re-format itself. Formatted for Printing

 By Li Lippman

How can you get the most out of your MDSG support group experience? In my many years as both a group member and facilitator, I’ve learned that there are many answers to this question. 

The experience starts even before the group does. MDSG runs about 16 groups a week between the two sites and when participants arrive, they must sign in and pick which group they want to attend. Some people choose by room because they like the consistency of the same room each week, no matter who the facilitator or other group members are. Other people like particular facilitators and will sign up for their favorite facilitator’s group regardless of where they are. Adventurous members may even try both Friday and Wednesday sites, attend groups run by any facilitator and try out any room. 

Which way is the best? It depends on the person, of course. For some, living in a city as unpredictable as ours with a very unpredictable illness means it’s nice to have the same routine every week. For others, mixing things up a bit each week is a good way to add variety to the often monotonous days of depression. 

No matter how you chose your group, though, it’s important to remember that support groups are about being around other people so considering them is as important as considering your own needs. Do what you can to make things run smoothly—it will not only help your fellow members, it will help you, too, by contributing to a better group dynamic overall.

So, number one, come on time. It’s such a rich experience to hear and feel how a group builds, unfolds and winds up from beginning to end, so you don’t want to miss anything. And of course it’s just plain disruptive and disrespectful to the others to come late.

Second, sign-up for a group at the sign-in table right away instead of waiting until the last minute before group starts. Signing up at the last minute makes it impossible for the leaders to know how many people are in each group and which is the best room for the group.

Third, when you sign up for a group, go to that group. Don’t switch groups. Again, you are creating a logistical nightmare for the administrators as well as compromising everyone else’s group experience if you go to a different group than the one you signed up for or switch groups part way through.

Fourth, practice listening. This may be the hardest part of all, but it’s important. After all, hearing other people’s stories is a crucial part of what makes the group experience such a valuable one. As a group participant, I find that listening makes me aware of what people are trying to tell me. Sounds so simple, but it can be a hard lesson to learn! And as a facilitator, I find that the more I let the members talk, the more I get out the group.

Fifth, attend some lectures. Sometimes, hearing a different professional perspective and the latest research helps me feel hopeful. I learn something at every lecture and get a sense of community with MDSG when I’ve been to a lecture.

So happy grouping. Whichever group you attend, whether you go regularly or sporadically, in the same room or different rooms, be considerate of others in the group and the leaders who are trying to make the groups work for everyone. See you all at the sites sometime soon! 

The phone is ringing, your e-mail in-box is full, your boss wants to speak to you right away and you’ve scarcely had any face time with your friends and loved ones all week. Can the stresses of modern society have an effect on depression and bipolar disorder? 

You bet they can, says Richard O’Connor, our June lecturer and author of the widely-praised book, Undoing Depression. Understanding how our bodies react to such stress is a key component in managing a mood disorder. “Our nervous systems are 160,000 years old and they’re just not designed for the level of input we have today,” says Dr. O’Connor. “And not only are we getting a lot of information, we’re getting a lot of conflicting information. With so many things to buy and so many opportunities, we’re told we’re supposed to be happy. But we don’t feel happy.” 

The constant adrenaline rush we feel as result of all this input means that cortisol—the so-called “stress hormone” — is constantly coursing through our bodies. That’s bad news for anyone, but for someone with a mood disorder it’s a major double whammy. “If we really want to get better, we need to be aware of how all of this comes into play,” says Dr. O’Connor. 

Come hear Dr. O’Connor speak about this important issue. His past MDSG lectures have packed the house and he is back by popular demand. This time, he’ll discuss the best ways to reduce stress—from lifestyle choices to mindfulness meditation and other relaxation techniques. Learn how to stop stress from running your life. 

More information about our lectures is available on the lectures page. 

Did you miss a lecture of interest to you? Most of the people who come to hear these experts speak, tell us how helpful the information has been. Not only do we find out about the latest scientific breakthroughs, but we also learn new coping skills from these cutting edge researchers, clinicians and authors. Cassette tapes of lectures from February 2002 through April 2004 are available for order. For more, see our lectures page. 

Ask the Doctors    with Dr. Ivan Goldberg  and  Dr. Joe Nieder

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Dr. Ivan Goldberg, Psychopharmacologist

Q: I have been taking Depakote for about two years and it has done a good job of stabilizing my moods. The one problem I have with Depakote is that since I have been taking it, I have been loosing my hair. Is there anything that can be done to reverse this side effect?

A: The hair loss that sometimes accompanies the use of Depakote (divalproex) seems to be the result of the drug’s effect on the body’s metabolism of copper and selenium. Taking supplements of zinc and selenium can often reverse divalproex-induced hair loss. About 25 mg of zinc and 100 mcg of selenium taken twice a day are usually effective. Minoxidil can also be helpful. 

Q: I have just about totally lost interest in sex since taking SSRIs. Is there anything that can be done about this?

A: There are a number of techniques for increasing sexual interest in people who have been taking SSRIs. Probably the most effective is to switch to an antidepressant, such as Wellbutrin (bupropion), Remeron (mirtazapine) or Serzone (nefazodone) that does not lower sexual interest. And among some of the medications that have been added to SSRIs to help people regain interest in sex are dexadrine, ginko biloba, Ritalin, symmetrel and testerone (as a patch), Viagra and Wellbutrin. 
 

Dr. Joe Nieder, Pediatric Psychiatrist

Q: My 17-year-old daughter has been on Zoloft for almost a year and it seems to be effective at controlling her depression. Now I read that SSRIs are linked to teen suicide. How can I tell if she's at risk?

A: If the Zoloft helps your 17-year-old daughter's depression, it should not be suddenly stopped because of the FDA warning concerning SSRI's and suicidal ideation. The FDA notice is simply a caution about suicidal risk, not a prohibition about the use of SSRI's. The information was gathered among various studies, with a pooling of information regarding possible negative effects of SSRI's in children. In the British data, there were no suicides in the children studied, but an increase in suicidal ideas. However, it is noted that depression as an illness may be accompanied by suicidal ideas or even suicidal attempts, even without the use of SSRI's, as part of the nature of depression. If the SSRI's were dramatically effective in the treatment of depression, the risk of increased suicidal ideas might be warranted. However, because it has been so difficult to demonstrate a therapeutic effect on depression in children, the benefit vs. risk ratio tips to greater caution. Of great importance is the warning that patients being treated for depression should not suddenly stop medication on their own, without medical supervision. 

The Reader’s Corner (Book Review) by Betsy Naylor  The Best Awful  by Carrie Fisher  269 pp. New York: Simon and Schuster, $24.

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Reading The Best Awful could be compared to listening to a terrific, book-length share in an MDSG group. I was completely drawn in by Carrie Fisher's story about a few years in the life of her bipolar character. The quirky, low-key tone and constant humor make for a fun read.

The story is set in a generic Hollywood, where Suzanne Vale lives with her 6-year-old daughter Honey. Bipolar Suzanne is stable on her meds, but a recent event has shaken her sense of herself: Her husband has acknowledged that he is gay and gone to live with his boyfriend.

In many respects, of course, the book is autobiographical. Suzanne’s circumstances overlap with many publicly known facts about Carrie Fisher: Fisher has also been diagnosed as bipolar for years, she has a daughter, and her former husband is indeed gay.

And in Suzanne’s musings, Fisher writes with an authenticity that only a person who has had the same feelings could pull off. Suzanne thinks back:  "...she'd never taken her bipolar diagnosis that seriously...She really considered it some quirky tendency...never an overriding issue...Suzanne thought it hilarious that there was an illness whose symptoms were spending sprees, substance abuse, and sexual promiscuity."

Inevitably, Suzanne's rationalizations talk her out of taking her medication.

"Suzanne had given regularity and calmness a fair run," Fisher writes. "The traits the doctors diagnosed and sought to medicate were some of her favorite aspects of herself."

Following her mother's ups and downs is Suzanne’s daughter, Honey. Suzanne knows full well that she is damaging Honey, but she can't help it. Honey has become a hyper-vigilant child always watching adults to figure out what her response should be. Suzanne is already planning for Honey's years of therapy. 

Not surprisingly, Suzanne becomes manic and her antics lead her into a dangerous, out-of-control scene requiring rescue. And that rescue ends in a one-way ride to the hospital. 

The hospital, with its likeness to jail, ever-present staff and obnoxious fellow patients, does not seem like a place to get better. But getting better happens inside a person. And Suzanne does get better.

Many people will enjoy The Best Awful. People with mood disorders will have the added treat of finding such an authentic character with a mood disorder.

You can purchase (and read more about) The Best Awful by Carrie Fisher from Amazon.com. Doing so will result in a referral fee being paid by Amazon to MDSG, at no cost to you. The paperback edition sells for $16.80 as of May 2004 (the price can change at any time). 

I once took a pill for my manic
It even smoothed out my panic
It quadrupled my weight
Despite what I ate
And my libido went down like Titanic

If you can’t laugh at mental illness, you’re crazy. So once again, here’s a contest with a humorous slant. It’s a reprise of one of this newsletter’s most popular competitions which last appeared seven years ago. To win you must write a limerick that follows the traditional form and style of this kind of ditty, but its subject has to be mood disorder topics like depression, mania, anxiety, medications, psychiatrists or any other aspect of this hilarious illness.

First prize: Dinner for two at Mumbles 
Second prize: A copy of Anne Sheffield’s latest book, Depression Fallout
Third prize: A tin of Nate’s famous brownies

Send your name, phone number and as many entries as you like to Limerick Contest, MDSG-NY, PO Box 30377, New York, NY 10011, or e-mail us at newsletter@mdsg.org. You must include your name and phone number. The decision of the judges is final. The deadline is July 7, 2004. Here are several more examples, but we’re sure you can do better:

My wife Mary spent all of our money
She also stopped calling me honey
She talks night and day
Changed her name to Tammy Faye
If it wasn’t so sad, it’d be funny

Henrietta’s home was a mess
“I’m not really a slob,” she’d confess
She never went out
“Oh God” she would shout
It’s just that I’m so damned depressed

Bill’s brain is all out of order
The doctor said “Bipolar Disorder.”
He just bought a yacht
With credit he don’t got
Maybe Bill’s shrink can afford her
   

MDSG provides award-winning services to New York’s entire mental health community---over 600 individual support group meetings a year, the distinguished lecture series, our telephone information service, web site and this newsletter. And all at the lowest possible cost, through volunteers.  The $4 contribution for meetings doesn’t cover all our expenses. We need your help to pay the phone bill, print the newsletter, promote MDSG in the media, and meet other needs.

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