M O O D S

by Jane Cartwright  

The Mood Disorders Support Group celebrates its 20th anniversary this year. Before it came along there was nothing like it in New York City. There was no place to share with others the challenges of living with mood disorders or to hear regular lectures from some of the world’s top scientists in mental health.

It began humbly enough—“more like a mom-and-pop store,” said Betty Mackintosh, co-founder and wife of MDSG Chairman Rich Satkin. MDSG was run from their apartment, where they and a handful of others returned phone calls, typed the newsletter, sorted all the mail. Mackintosh remembers licking “many, many stamps” and frequent “work parties” that finished up with pizza and soda. Satkin recalls the mosaic of paper spread out on the floor while the mail was sorted by zip code. Later it was carried to the main post office and sent bulk rate. This saved money.

Twenty years later, MDSG sends out more than 6,000 newsletters quarterly and runs more than 800 support groups a year in three city locations. It’s still an all-volunteer organization reaching approximately 10,000 people annually. Speakers deliver state-of-the-art lectures 10 times a year. Many people find out about us on the Internet where our website is meticulously kept up to date. Others find out from their doctors who recommend participation.

The name MDSG invokes wide respect. Recently, Satkin and Mackintosh sat down to talk with board members Marylou Selo and Ngaere Baxter, Ph.D., (also a co-founder) about why, when and how this remarkable organization got started.

In 1981, Satkin and Mackintosh wrote a letter inquiring about a support group to Ronald Fieve, M.D., at the Foundation for Depression and Manic Depression where Dr. Baxter, a psychologist, was clinical director. “The foundation was undergoing some major changes, and there was nobody who particularly wanted to take on such a task,” said Dr. Baxter. “But it seemed to me something I would very much like to do, so I invited the two of them to my office on 67th Street. I remember the day vividly.

“We immediately found that we shared many common ideas about how valuable a support group would be in an era when treatment of depression and manic depression had become heavily ‘medicalized’ and ‘clinicized.’ Many people couldn’t afford psychotherapy, but they needed some support in addition to medication. “So we set about putting everything in place—deciding where and when we should meet. I was running around buying cookies and making coffee for the meetings,” she said.

“I would like to give a lot of credit to Dr. Fieve and Ngaere, because they knew people from different walks of life and different situations who, like us, had made some inquiries,” said Mackintosh. “They did the ground work and the initial telephoning and offered us the space to meet. . . Basically, if it wasn’t for them, we would never have gotten started—at least in this context. “It seemed incredible to me then,” she said, “that there was no support group in the city that dealt with patients’ and family members’ issues.”

“I don’t find it that surprising,” said Satkin. “Because back then—even more so than now—many psychiatrists dispensed medication only. They had little or no interest in starting support groups. It was up to consumers to do that.”

In the meantime, in May of 1981, Selo was released from Roosevelt Hospital after she suffered what was called “a nervous breakdown.” “A social worker there told me I would never work again, and that I could forget about returning to my career as an interpreter, translator and tour guide,” Selo said. “I was told the best I could hope for would be volunteer work somewhere. Quite by coincidence, I found the foundation of Dr. Fieve. He was looking for someone to work the telephones, and I remember I never did a job as badly as I did this one. It was a nightmare.

“One day Dr. Fieve came storming down the stairs, because I had misconnected him again, and he said: ‘What did you do before this?’ I said I was an interpreter, and he said ‘What are you doing here?’ “I told him a little bit about my history, and he said, ‘I think it would be very good for you to be in a support group,’” recalled Selo. “I had never heard of a support group. I didn’t even know what one was.” She attended the first meetings of MDSG. (Oh, and by the way, eventually she did work again, and her career now takes her around the world.) 

In the early years, psychiatrists were “suspicious” of mental-health support groups, according to Satkin and Selo. “Rich and I were hand delivering notices about MDSG to doctors’ offices,” she said. “In 1984, we had very simple brochures, and we wanted to give them to psychiatrists attending the American Psychiatric Association convention at what was then the Americana Hotel (now the Sheraton). “We had to stand on the sidewalk or out on the steps of the hotel to hand them out, because we were seen as evil—as anti-psychiatry.”

Added Satkin: “Today there are many more psychiatrists open to support groups . . . We know that. Doctors want to come to us. They’re our friends, but they weren’t in 1981.” “Perhaps the perceived threat was their fear that we might encourage people not to take their medication or to do something that was not medical—some alternative thing,” said Mackintosh. But, of course, that’s not what happened.

Early groups met in the Medical Arts Center “to swap war stories,” Mackintosh remembers. “We usually had only one space, two if we were lucky. When we broke up into discussion groups, group number one would be over here for family members like me. Group number two would be over there and so on. Every group would be talking at once.” Now, of course, groups meet—if not in their own rooms--then in their own partitioned space.

Have the original goals of MDSG been met or exceeded?

“Exceeded, definitely,” said Selo. “They were met a long time ago,” said Satkin. “The initial goal was to form a place where we could meet and talk and learn something.” But the organization, he added, quickly branched out to offer lectures and extensive group-facilitator training. The mission, however, has remained the same.

“When I first got sick in 1976,” said Selo, “I thought, ‘Okay, they tell me this is going to take six or eight weeks. Then I’m going to be able to go home, take the cast off, so to speak, and walk again.’ “No one told me that this illness might come back. No one told me I would have to stay on my medications to keep the episodes from coming back—that I was in this for the rest of my life—that there was no cure.” She learned much about her bipolar illness from support-group members.

What will MDSG look like 20 years from now?

“I think it would be great if MDSG had more ethnic and economic diversity,” said Mackintosh. “And maybe there could be a telephone hotline.” “We really should be tackling stigma by then,” added Satkin. “We could be doing mental-health advocacy throughout the Tri-State Area.” “I think in 20 years—if everything were ideal—there would be no need for us to exist at all,” said Selo. “But this won’t happen. It would be good, however, if every school child before the age of 15 were taught about mental illness just as they are taught about cancer or heart disease. “If kids grew up this way, stigma eventually would vanish.”

If you could say one thing your experience with MDSG has given you personally, what would it be?

“Interesting question,” said Dr. Baxter. “I’ve made lots of friends. I’ve enjoyed the people very much. And I think it’s given me a sense of power in a way that I couldn’t have had as an individual practitioner . . . With MDSG, I can put my patients in touch with something they typically don’t anticipate—the fact that they belong to a body of people who can be effective in their lives. It’s a place to go, a place to meet people, a place to learn.”

“MDSG has helped me take the complete disruption of my career and aspirations and turn it into something positive,” said Satkin, who earned a master’s degree in finance from New York University but suffered a manic episode before he could put the degree to work. Instead, he turned an earlier master’s degree in urban planning (also from NYU) into a career of civil service in the City Department of Planning. 

Mackintosh, who holds a Ph.D. in environmental psychology, also works there. “With the success of MDSG, I have the personal satisfaction of having been a part of creating something good in the world,” Mackintosh said. “It was a healing experience for us after the trauma of the years of illness before. It was a way of putting ourselves back together again.”

“My work with MDSG has brought me enormous fulfillment,” said Selo, who helped set up in 1986 the National Depressive and Manic-Depressive Association, with which MDSG’s is affiliated. “But most of all,” Selo added, “now that my family is gone, the friends I’ve made at MDSG have become my family.”

Happy Anniversary MDSG. 
May there be many more! 

From the Chair

by Rich Satkin, Chairperson of MDSG 

The article about how MDSG got started and why inspired me to focus on a long-neglected matter: volunteers like Jane Cartwright, newsletter editor, who are the lifeblood of our organization.

Our 20th anniversary is a great time to acknowledge everything that volunteers do. People outside MDSG are very impressed that we are an all-volunteer organization. Thriving for 20 years without a paid staff is quite an accomplishment. 

While I can’t thank all of you here by name, let me, at least, point out some of the things you do. You facilitate more than 800 support groups a year, serve on the board of directors, book lecturers and set up support groups and lectures. You write, edit and copy edit the newsletter, answer telephone calls, update our excellent website, run facilitator training classes, schedule 14 facilitators every week, put up signs and move furniture to accommodate support groups at three city locations, and keep up the membership database. Some of you collect admission fees and donations, pick up mail, go out into the community to talk about our services or to raise funds. Others answer correspondence or track MDSG money and keep our books in a professional manner. And the list goes on.

Although these tasks may seem mundane, they are essential to making things work. No task is too small to count in the overall effort to keep MDSG up and running. Indeed, things go so well, outsiders are surprised often when they learn that no one is paid! 

What is the key to our success and longevity? First, it’s the dedication of people with mood disorders to helping MDSG fulfill its mission—to offer support and education to others so afflicted and their families and friends. Second, working for MDSG gives members the chance to experience the kind of satisfaction or fulfillment usually associated with a job. Many people with mood disorders find their careers shattered-—especially if the illness strikes early. MDSG volunteers take their jobs very seriously, and their performance is every bit as solid as if they were paid. Their volunteer work may or may not be a step towards an income-producing job, but the self-confidence and self-esteem gained go a long way in improving the quality of their lives. 

Finally, I’ve observed over the years, that more volunteers (family members, friends and consumers) have stepped in to help as MDSG’s standards and performance have improved.  These factors are an important part of the “secret” of our longevity, and are the key to our future. As we celebrate our anniversary, I thank everyone who volunteers.

How a Mother’s Depression Affects Her Child

Author Anne Sheffield Will Discuss This at a Lecture May 7, 2001  

by Jane Cartwright  

Two of three people diagnosed with depression are women, often in their child-bearing and child–rearing years. How are their children affected? What happens to them as adults?

On May 7 Anne Sheffield, author of Sorrow’s Web: Overcoming the Legacy of Maternal Depression, will address this topic. She spoke last year on How You Can Survive When They’re Depressed: Coping With Depression Fallout, the title of her first book. She describes herself as both the daughter of a depressed mother and a depressed mother herself. During a recent interview, she talked about what happens to children and adult offspring of depressed mothers.

“According to the research, infants are more irritable and fussy and harder to soothe,” she said. “Toddlers very often have tantrums; they lack emotional control. School-age children have the same problems, plus a combination of poor attitude and poor performance in school. Very often they find it difficult to fit in socially, to make and keep friends. They often have problems with authority and are more apt to experiment with drugs or alcohol.”

Q. The most serious effect, you say, may be impairment of a child’s ability to learn. Please explain.
A. There have been research studies that claim that IQ is somehow affected by maternal depression. I don’t find the evidence persuasive. I think a child whose mother is depressed is under a great deal of pressure. There is probably enormous strife in the household, and this makes it difficult for a child to make school a priority. The child may not live up to his or her academic potential.

Q. You write, “Although I have never seen mention of this in the research, I suspect that depressed mothers are particularly prone to competing with their daughters.” Was this your experience?
A. Yes, my depressed mother was certainly “jealous” of my success and undermined me in every conceivable way—from belittling my job to criticizing my friends. She was a very negative person. But, perhaps, “resentment” is a better word than “jealousy.” Depressed people are resentful of just about everything.

Q. Some people listening to you or reading the book may be trying to figure out if, in fact, their mother was depressed. Are there any characteristics of adult offspring that send up a red flag?
A. If you’re wondering about this, I would go back and look at the kind of emotional baggage you carry. I have a striving for perfection combined with the secret conviction that I’m a fraud—just clever enough to keep other people from knowing it. My self-image was low, and no matter how hard I tried, and no matter how successful I was, particularly in my work, I never really felt great about myself. Then one day it dawned on me why I felt this way: I could have achieved much more in life if I had had more emotional control.

Q. You write about how difficult it was to grow up believing you were lovable when you felt unloved by your mother. Do you feel lovable now?
A. No. My theory is that if you grow up not getting the love, support and approbation of your mother, it’s going to be difficult for you to believe you are lovable.

Q. How did you feel after your mother died?
A. Well, I have to say that I was glad she was gone, but the real understanding didn’t come until I realized she was depressed for years and years, and this ruined her life and made it very difficult for me.

Q. How did this realization help you?
A. Because then I realized that it wasn’t my fault. And I felt tremendous relief.

Q. In the book your daughter, Pandora, says she supports and loves you but declines to comment on growing up with a depressed mother. How’s she doing now? And what’s your relationship like?
A. She’s very professionally successful. She says she won’t stop taking her antidepressants until the day she dies. Like me, she’s made some terrible choices with men, but now she’s living with a very nice man. They don’t want to have children. Certainly, she’s had some trouble with intimacy, but since she’s read what I’ve written, I think it’s the first time she’s really believed that I have always loved her.

Ask the Doctor        with Dr. Ivan Goldberg

Q. My doctor put me on Glucophage, because he said it might help me lose weight and make my antidepressant more effective. But it's a drug for diabetes, and I don't have diabetes. How does it work?
A. In people without diabetes, Glucophage alters the body's reaction to insulin. This sometimes makes it easier to lose weight. I am not aware of any research suggesting that Glucophage increases the effectiveness of antidepressants.

Q Is Trileptal a new, improved Tegretol, as my doctor says? Will it be more effective as a mood stabilizer? Have fewer side effects?
A. Trileptal is a modified form of Tegretol. It seems to have fewer and less severe side effects. While there is not much research on its effectiveness as a mood stabilizer, it is probably as effective as Tegretol.

Q. What is the relationship between depression and chronic pain? How can my doctor determine which is which and treat accordingly?
A. The relationship between depression and chronic pain is complex. About 80 percent of people with moderate to severe depression complain of chronic pain, mostly headaches and/or backaches. With successful treatment of the depression, the pain usually disappears. It works the other way around, too. Chronic pain induces depression in some people. For them, successful treatment of the pain relieves the depression.

West Side Carnegie Hall Group Now Meets Every Week

In response to growing demand, MDSG’s West Side Carnegie Hall support groups now will meet every Wednesday evening instead of every other week. Groups meet at 120 West 57th Street. MDSG's two other branches in New York City meet on the East Side at Beth Israel Medical Center every Friday night and in Brooklyn every other Tuesday.

In the 20 years since it began, MDSG has grown to include 14 support groups a week, 10 lectures a year, a quarterly newsletter and a website. Annually, MDSG reaches about 10,000 people. We remain a self-help, all-volunteer organization striving to provide a compassionate environment where consumers, family and friends are treated with empathy and respect. See you there! 

Contest Winners

What’s Funny About Being Sick

The winner of the last contest, “What’s Funny About Being Sick,” was M.W., New York City, who writes with creative flair:

“This morning’s shock treatment obliterated your manic episode.
“That is good to know, Dr. Wright [name changed]. Am I free to go home now?
“I’ll see you next week. Stay calm.”
As I walked along the long highway leading to my apartment building, I suddenly looked at my left hand and realized that if I turned it a certain way, the world would end. The temptation to move my hand was overwhelming. I tried with all my effort to keep from re-positioning it. Cars sped past me. I used the other hand to try to hitch a ride, but drivers only gave me looks of curiosity. Finally, a car stopped and a blonde head emerged from the window.
“Can I help you, Margaret?”
It was Dr. Wright!
“Please help me get home!
“What’s wrong?’
“The world is going to end!”
The next morning, an apologetic Dr. Wright administered the shock himself.

M.W. wins a $25 gift certificate to Pamela’s Café in Greenwich Village.

The second-place winner is a member of the youth group:

My name is J.H. I am thirty-one years of age. I have suffered from bipolar disorder most of my life. I managed to graduate from college in 1992 and then held several high-profile business jobs. Working with a handicap, I often experienced rather comical adventures. My co-workers didn’t know I suffered from depression. In the fall of 1993, I was an employee at a world-renowned, British-based magazine.

Because of my deep depression, I was always extremely fatigued. During my lunch hour, I looked for a secluded place in the office building to take a nap. One day the president of the company was away in Europe on a business trip. Like most CEO’s, she had a very large desk. I thought to myself, “This is a perfect. . . I’ll take a nap under her desk. After all, no one was in her office.”

And so I proceeded—in my suit and tie--to crawl under the president’s desk, which, by the way, was very accommodating. I lay on the plush, thick carpet and fell promptly asleep. Twenty minutes or so later I heard a distant sound . . . As a precautionary measure, I lifted my head up ever so slightly above the desk to see if anyone was there. To my great shock, the vice president was standing in the doorway, looking at me. The expression on her face was one of utter bewilderment. Not knowing what to do, I simply smiled and waved. She retreated without asking any questions. Ironically, I didn’t lose my job then, but did several months later for chronic absenteeism.

J.H. wins a copy of The Essential Guide to Psychiatric Drugs, by Jack Gorman, M.D.

The third-place winner couldn’t resist the opportunity to mock the third prize—a 28-slot pill box and pill cutter. So, she -- Bea June--wins it. 

"Mood disorders aren't funny, but sometimes humorous things happen to us because of our illnesses. Well, what's so funny about being sick is this: I’m sparked to enter this contest because the third prize, a seven-day, 28-slot-pillbox intrigues me so. What a hook!” 

We Get By with a Little Help from Our Friends . . . 

MDSG provides award-winning services to New York’s entire mental health community---over 800 individual support groups a year, the distinguished lecture series, our telephone information service, 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..

About  MDSG

MDSG/NY sponsors a series of  lectures on various aspects of mood disorders. Anyone can attend our lectures. More information is available on our lectures page at www.mdsg.org/lectures.html. Our next lectures are:

New Approaches to Treatment of Chronic Depression 
Monday,  March 5, 2001  James H. Kocsis, M.D. 
Chronic depression is defined as a depression that has lasted for at least 2 years without remission,  Treatment for chronic depression needs to not only reduce depressive symptoms, it must also improve one's quality of life. Dr. Kocsis will discuss the role of anti-depressant medications and effective approaches to the psychotherapy of chronic depression. 

What to do When Drugs Dampen Sexual Pleasure 
Monday,  April  2, 2001  Barbara Bartlik, M.D. 
What do you do when your antidepressant seems to be working, but the side effects are killing your sex drive? Although psychotropic medications can cause sexual dysfunction, there are ways to beat it. Dr. Bartlik, a psychiatrist, and sex therapist will discuss ways men and women can increase their sexual pleasure when drugs are dampening their libido.