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
August 2004	Table of Contents (all articles are on this page) September Lecture: Mood Disorders and Sleep Letter From The Chair Ask The Doctors The Reader's Corner Announcements And The Winners Are . . . We Get By with a Little Help from Our Friends . . . Contact MDSG	When printed, this page will automatically re-format itself. Formatted for Printing

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 June 2004 are available for order. For more, see our lectures page. 

Often at MDSG groups, it may not be obvious who we have helped. Each week, group members offer each other support, hope, comfort, experience, and a chance to identify, but sometimes our words drift into the air and land where we might not expect. We may never be aware of it, but someone may remember our ideas days or even weeks later and find them valuable. 

Recently, MDSG received an e-mail prompting me to point out this special phenomenon: You never know when something you say will touch another person. The e-mail was from a woman who attended Friends and Family on Wednesdays. Her daughter had committed suicide two years before and she had still not found any help. I wondered if she had found the appropriate group. She repeated her horrific story in a way that made it seem like she was not moving forward in her struggle. But then I read what she had to say. 

"When all goes so wrong, when the family gets lost in circles, when finding the way through insurance and medical systems becomes an overlay in the unexpected nightmares, finding a forum like the MDSG is surely a step towards some relief. I loved the group. I will remember persons who passed on their stories, their expressed love, their search for relief. I consider them my friends, although I just remember either the first name or just the very special story. 

"Congratulations to all of you who contribute to the MDSG! You love it and we feel it” Our e-mail writer thanks you and I thank you, all of you.

by Betsy Naylor
Mood Disorders Support Group Chair

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

Top Of Page

Dr. Ivan Goldberg, Psychopharmacologist

Q: I have been depressed for three years and have not felt better despite psychotherapy.  Recently, I took Ultram for a painful foot and experienced more relief from my depression than I had with any antidepressant.  Why is that? And now that my foot is better, can I get it prescribed for my depression?

A: Ultram (tramadol) is a non-narcotic analgesic that has been reported to relieve symptoms of depression in some people who were not helped by conventional antidepressants. The mechanism by which it relieves depression is not known. Unfortunately, as with some other strong analgesics like Percoset or Oxy-Contin, the use of tramadol often causes addiction and the need to be de-toxed as it is fairly easy to become dependant on it. For this reason, it wouldn’t be an appropriate treatment for your depression.

Q: I have bipolar II disorder and am depressed.  My doctor has started me on Wellbutrin. When I asked him about the possibility of the Wellbutrin inducing mania, he said that it didn't do that.  Is that true?

A:  There is no antidepressant that has not induced mania in some people. Although it may be that Wellbutrin (bupropion) induces mania less often than other antidepressants, more research is needed to support this assertion. There is also some evidence that the MAOIs phenelzine (Nardil )and tranylcypromine (Parnate), and the non-MAOI venlafaxine (Effexor) might also be less likely than other antidepressants to cause mania in people with bipolar II. 

Because of the life-threatening nature of depression, people with all forms of bipolar disorder may require antidepressants at certain points in their lives. The dangers associated with the use of antidepressants are less than the risk of suicide and major disruption of work, play, sex and family, associated with depression.  

Q: My twin sister developed post-partum depression following the birth of her first child. Does that mean I'm likely to have a depression when I have a baby?

A: Not necessarily. A study of 838 twin pairs looked for genetic influences on the likelihood of developing post-partum depression and only a modest relationship was found between one twin developing it and the other one having the same problem. A much strong predictor of post-partum depression is a history of bipolarity.  About two thirds of  women with bipolar disorder have a post-partum mood episode, nearly always depressive, within a month of delivery.

Dr. Joe Nieder, Pediatric Psychiatrist

Q: My ten-year-old son was recently diagnosed with ADHD. He has been taking Ritalin for a month but doesn’t seem to be improving. Would you add another type of medicine—like an antidepressant—to the Ritalin? 

A: If the diagnosis is correct and the problem is ADHD alone, it would make more sense to try a different stimulant (like Adderall or Dexedrine) instead. The response rate to stimulants for ADHD children is quite good, and you would see the results quickly, whereas with an antidepressant you might not see any results for weeks. Another option might be Strattera, a non-stimulant drug for ADHD which came on the market last year. 

Q: My teenage daughter’s psychiatrist started her out on Depakote for depression and anxiety. I was surprised he didn’t use an antidepressant. Is this a common treatment for teenagers?

A: It’s something that we’ll probably be seeing more of. The risks associated with antidepressants in children and adolescents seems much greater than the risks associated with mood stabilizers, so your daughter’s doctor is starting with the more cautious option. It’s important not to rush antidepressants for children or adolescents with any potential for agitation or development of suicidal ideation. One must be very cautious not to induce rapid cycling bipolar disorder in the patients as this is far more difficult to treat. Stabilized mood is the optimal outcome. Once mood is stabilized, then stimulants or antidepressants may be considered.

The Reader’s Corner (Book Review)   by Li Lippman   Opening Skinner’s Box: Great Psychological Experiments of the Twentieth Century   by Lauren Slater    256 pp. W.W. Norton & Company, $25.

Top Of  Page

In her most recent book, psychologist and writer Lauren Slater takes a look at some of the landmark psychological experiments of the past hundred years. In a departure from the way psychology is taught in school, where we often memorize information only to forget it after the exam, Slater's narrative transforms these experiments from the dry journal articles from which they sprung into vibrant stories. She makes the quantitative into qualitative, the researchers into characters, and the science into art. In the process she takes a certain amount of literary license to tell each story as a narrative.
 
In the field of psychology, it seems like everyone has an opinion about Slater: Most people either love her approach or hate it. I have mixed feelings myself. Other reviewers have taken issue with the book's accuracy. For example, the New York Times book review said that she misspelled words, misquoted sources, and failed to check facts. And of course, in describing probable events that happened half a century ago, she must have imagined (rather than known) what a researcher was doing or thinking. This does tend to blur the line between fact and fantasy. 

But little is mentioned in the past reviews of Slater’s writing. I think she is a writer first and a psychologist second. Having read her other books, I am familiar with her writing and I like it. (And if you would rather just enjoy her writing and not worry about the details, I recommend some of her other books, Love Works Like This, Prozac Diary and Welcome to My Country.) Still, in this case, I was irked by the way she used this style to describe what I learned in an academic setting. Even though her approach is unique and provocative, I’m not sure it works here. 

What does work, though, are the questions she explores. For example, in the famous Stanley Milgram experiment of obedience and authority, subjects were directed by the experimenter to administer shocks to a person whom they could hear screaming in pain and begging for help. The shocks were fake, but the subjects did not know this, and an astonishing 65% of them obeyed authority and continued to administer shocks even when they thought they were lethally hurting someone. Slater asks whether Milgram was able to sleep well at night during this experiment. What kind of subject followed orders to the point of hurting another human being and what was the aftermath of such an experiment? What kind of subject did not follow orders? Slater manages to interview a couple of subjects from the experiment and she begins to find answers to these questions.

Slater provokes thought and never stays on the surface. She is a risk-taker. In one chapter she actually replicates David Rosenhan’s famous study in which sane volunteers faked their way into mental institutions and then once inside, acted normal. Slater herself tried to fake her way into a ward. This was brave; I’m not sure I could do it. But in doing so, she reveals some changes since the original experiment. Admission staff treated her humanely, and she was not admitted to the hospital.

So learn what you can from this book because there is a lot of good information here. Open your mind to the questions she brings up, but don’t get too wrapped up in the details that may be inaccurate. For anyone who hasn’t studied psychology in school, it’s a quick and unusual crash course of the last 100 years of the field. Only a Kaplan quicky-review for the Psychology GRE may be faster. If you do have a psych background, chances are you know these experiments, but Slater may make you think about them in a whole new way. 

Li Lippman is a graduate student in psychology at New School University.

You can purchase (and read more about) Opening Skinner’s Box: Great Psychological Experiments of the Twentieth Century by Lauren Slater from Amazon.com. Doing so will result in a referral fee being paid by Amazon to MDSG, at no cost to you. The hardcover edition sells for $17 as of August 2004 (the price can change at any time). 

Twenty- something?

Beginning in September, the Youth Group at the Beth Israel location will be renamed the "Twenty-something Group."  Accommodations for those over thirty will be provided in a separate group when possible.

SUPPORT MDSG - PAINLESSLY!

MDSG has an affiliation with Amazon.com. If you go to our website (www.mdsg.org) and click on the Amazon logo, you’ll be taken directly to Amazon’s site. As long as you have reached their site through ours, MDSG will receive a commission on anything you buy from them -- books, movies, music, or any other merchandise they offer for sale. It’s that simple! 
  

Sometimes, laughter really is the best medicine. So in our last issue we asked you to put pen to paper and compose limericks that poke fun at depression, medications, treatment or any other aspect of mood disorders. Why? Because as one entrant explains, “If we can laugh at mental illness and ourselves, it means we are not so sick.” Judging from the terrific response, many of you agree. So without further ado, here are the top entries:

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.

Annual membership is $35 for individuals, $50 for families. Your membership card is a free ticket to support groups and most lectures. Contributions are tax deductible. So be a friend of MDSG--support us as we support you! Memberships and contributions to MDSG are tax-deductible to the extent allowed by law. MDSG is an IRS-recognized 501(c)(3) organization.

SUPPORT MDSG - PAINLESSLY! Shop at Amazon.com

MDSG has an affiliation with Amazon.com. If you click on the above Amazon logo, you’ll be taken to Amazon’s web site. As long as you have reached their site through ours, MDSG will receive a commission on anything you buy from them -- books, movies, music, or any other merchandise they offer for sale. It’s that simple! 

Letters to the editor and other submissions are welcome and will be printed at the discretion of the newsletter editor. Contributions can be mailed to our Post Office Box (see above), please address them to "Newsletter Contributions".  E-mails should be sent to newsletter@mdsg.org  

Subscribe to the MDSG feed

For questions or problems contact webmaster@mdsg.org