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Mental Health News

Following are the latest news and information resources for the various mental health topics that we cover. We hope you will find the news educational and the links in the resources section useful in helping you to get even more in-depth data.

Schizophrenia Gene Corrupts Neural Connections

Researchers have long suspected that major mental disorders are genetically-rooted diseases of synapses – the connections between neurons. Now, investigators supported in part by the National Institutes of Health have demonstrated in patients' cells how a rare mutation in a suspect gene disrupts the turning on and off of dozens of other genes underlying these connections.

"Our results illustrate how genetic risk, abnormal brain development and synapse dysfunction can corrupt brain circuitry at the cellular level in complex psychiatric disorders," explained Hongjun Song, Ph.D. , of Johns Hopkins University, Baltimore, a grantee of the NIH's National Institute of Mental Health (NIMH), a funder of the study.

Song and colleagues, from universities in the United States, China, and Japan, report on their discovery in the journal Nature, August 18, 2014.

"The approach used in this study serves as a model for linking genetic clues to brain development," said NIMH director Thomas R. Insel, M.D.

Most major mental disorders, such as schizophrenia, are thought to be caused by a complex interplay of multiple genes and environmental factors. However, studying rare cases of a single disease-linked gene that runs in a family can provide shortcuts to discovery. Decades ago, researchers traced a high prevalence of schizophrenia and other major mental disorders – which often overlap genetically – in a Scottish clan to mutations in the gene DISC1 (Disrupted In Schizophrenia-1). But until now, most of what's known about cellular effects of such DISC1 mutations has come from studies in the rodent brain.

To learn how human neurons are affected, Song's team used a disease-in-a-dish technology called induced pluripotent stem cells (iPSCs). A patient's skin cells are first induced to revert to stem cells. Stem cells play a critical role in development of the organism by transforming into the entire range of specialized cells which make up an adult. In this experiment, these particular "reverted" stem cells were coaxed to differentiate into neurons, which could be studied developing and interacting in a petri dish. This makes it possible to pinpoint, for example, how a particular patient's mutation might impair synapses. Song and colleagues studied iPSCs from four members of an American family affected by DISC1-linked schizophrenia and genetically related mental disorders.

Strikingly, iPSC-induced neurons, of a type found in front brain areas implicated in psychosis, expressed 80 percent less of the protein made by the DISC1 gene in family members with the mutation, compared to members without the mutation. These mutant neurons showed deficient cellular machinery for communicating with other neurons at synapses.

The researchers traced these deficits to errant expression of genes known to be involved in synaptic transmission, brain development, and key extensions of neurons where synapses are located. Among these abnormally expressed genes were 89 previously linked to schizophrenia, bipolar disorder, depression, and other major mental disorders. This was surprising, as DISC1's role as a hub that regulates expression of many genes implicated in mental disorders had not previously been appreciated, say the researchers.

The clincher came when researchers experimentally produced the synapse deficits by genetically engineering the DISC1 mutation into otherwise normal iPSC neurons – and, conversely, corrected the synapse deficits in DISC1 mutant iPSC neurons by genetically engineering a fully functional DISC1 gene into them. This established that the DISC1 mutation, was, indeed the cause of the deficits.

The results suggest a common disease mechanism in major mental illnesses that integrates genetic risk, aberrant neurodevelopment, and synapse dysfunction. The overall approach may hold promise for testing potential treatments to correct synaptic deficits, say the researchers.

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A Natural Way To Cope With Anxiety

I first started experiencing extreme anxiety around the age of 17 following a traumatic event. This initial episode was so bad that along with frequent and debilitating panic attacks, I also experienced another painful side-effect to my anxiety, which was an acid-reflux condition so bad that it left my esophagus awfully damaged. I wasn't able to eat anything solid for about a week and a half, couldn't speak properly and swallowing was excruciating.

The funny thing was that I didn't even realize that I was suffering from extreme anxiety when I attended my appointment with the doctor for my acid-reflux problem. It wasn't until he began asking me questions and finally prescribed me with the anxiety drug Lorazepam, that I actually realized that I was feeling anxious in relation to my situation at the time. The reality was that I was so disconnected from my emotions that my body was forced to manifest some serious physical symptoms just so I would no longer ignore how I was feeling.

This is why mindfulness is such a powerful and transformative tool in dealing with stress and anxiety. I only wish that I had known about it all those years ago; personally, in the long-term it would have been a lot more effective for dealing with and preventing anxiety than waiting for it to happen and popping a pill.

Although I understand that medication is necessary for some people to handle their conditions, I strongly believe that all too often both doctors and patients are too quick to jump to the conclusion that the only way forward is to medicate. There needs to be a more holistic approach that explores solutions that really help people to help themselves.

Respected educator, speaker, and psychiatrist, Dr Suvrat Bhargave describes anxiety as a 'false alarm'. Anxiety is our primal 'fight or flight' response. In today's modern lifestyle, where we're not being threatened by a mammoth or stalked by a saber-toothed tiger, it means that chronic anxiety is sounding off an alarm when there is no real physical danger there. Dr Bhargave explains that the first step in dealing with anxiety is acknowledging that your thoughts (beliefs and perceptions) are causing your brain to keep falsely sounding the alarm.

The good news is that through mindfulness and gentle, yet persistent self-coaching, we can teach ourselves to turn off the alarm. To do this we must be willing to have a dialogue with ourselves and to actively monitor our thoughts and feelings. Anytime we begin to feel the physical symptoms of anxiety taking hold in our body, it's time to stop and speak to ourselves with a calm, reassuring but firm voice and explain that we are safe.

Affirmations can work wonders in these situations. We can affirm the following things: I am safe, I am well, I am always able to choose my response to any situation. Combining affirmations with conscious breathing exercises (breathing in I acknowledge my anxiety, breathing out I let go of my anxiety) can help to instantly calm our thoughts and our physical symptoms as well.

Once we are more readily in touch with or conscious of the thoughts and feelings that trigger an anxious response, it may be that we are in a better position to start voicing them to someone we can trust. Often even just the verbal acknowledgement that we are feeling a negative emotion can have a hugely healing effect.

Sometimes anxiety can be linked to a psychological trauma that has taken place when we were younger. That's why many people find it beneficial to write a letter to their inner child, explaining that there is no longer a need to worry or feel anxious, that they are now an adult that can look after themselves and that they are safe. If you've been suffering from ongoing anxiety, why not take half an hour for yourself and try this exercise to see if it helps?

I'm a firm believer that if there's a will, there's a way. If anxiety is taking over your life, it's time to take back control. Commit to confronting and monitoring your thoughts and feelings and gradually you'll be able to turn off anxiety's false alarm.

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Insomnia Drug Linked To Doubling Of Hospital Emergency Visits

New analysis from the Substance Abuse and Mental Health Services Administration (SAMHSA) shows that overmedicating with the insomnia drug zolpidem led to a near doubling of emergency department (ED) visits in the United States during the periods 2005-2006 and 2009-2010.

The new Drug Abuse Warning Network (DAWN) report from SAMHSA shows that there were 21,824 ED visits in the earlier time range vs 42,274 visits in the latter.

Although these types of visits increased between the 2 time ranges by 150% for men vs 69% for women, 68% of all zolpidem overmedication visits in 2010 were from women.

"Sleep aid medications can benefit patients, but they must be carefully used and monitored," said SAMSHA administrator Pamela S. Hyde in a release.

"Physicians and patients need to discuss the potential adverse reactions associated with any medication and work together to prevent problems or quickly resolve any that may arise," she added. The DAWN report was released on SAMHSA's Web site August 7.

FDA Warnings

Zolpidem is approved by the US Food and Drug Administration (FDA) for short-term treatment of insomnia. It is also the active ingredient in several brand name sleep aids, including Ambien (sanofi-aventis), Edluar (Meda Pharmaceuticals, Inc), and Zolpimist (NovaDel Pharma, Inc).

Last year, because of numerous reports of adverse reactions from the ingredient, the FDA required companies manufacturing zolpidem-containing medications to lower the recommended dose by 50% for women. Although not a requirement, it also recommended that the dose be lowered for men.

Plus, "when zolpidem is combined with other substances, the sedative effects of the drug can be dangerously enhanced," writes SAMHSA in a release.

As reported by Medscape Medical News, another SAMHSA report released last week showed that 96% of ED visits in 2011 due to drug-related suicide attempts in those between the ages of 45 and 64 years involved over-the-counter medications and/or the nonmedical use of prescription drugs. Of these, 48% involved antianxiety and insomnia medications.

The new SAMHSA report is based on findings from DAWN reports released between 2005 and 2010.

It showed there were 4,916,328 drug-related ED visits in 2010, of which 20,793 were caused by zolpidem overmedication.

A total of 57% of the 2010 zolpidem overmedication-related visits involved other prescription drugs. Of these, 26% involved benzodiazepines, 25% involved narcotic pain relievers, 19% involved antidepressants, and 14% involved antipsychotics. A total of 14% of these ED visits were from a combination of zolpidem and alcohol.

Of all 2010 overmedication-related visits using zolpidem, 47% resulted in being admitted to a hospital or being transferred to another medical facility. A total of 26% of these resulted in admission to a critical care or intensive care unit.

The age range with the largest proportion of zolpidem-related ED visits in 2010 was between 45 and 54 years (31%). This was followed by those younger than 35 years (23%), those between the ages of 35 and 44 years (21%), those between the ages of 55 and 64 years (14%), and those older than 64 years (11%).

Finally, the number of these types of ED visits increased for men from 6607 in the 2005-2006 date range to 16,523 in 2009-2010 vs an increase for women from 15,216 to 25,749.

Preventing Overmedication

"Adults of all ages can help prevent overmedication by closely following the instructions for when and how to take all medications," the report notes.

"If symptoms persist when the recommended amount of zolpidem is taken, patients should consult their prescribing physician," they add.

SAMHSA notes that several major efforts are under way to promote prevention of prescription drug–related problems.

These include the organization's Strategic Prevention Framework Partnerships for Success II and the "Not Worth the Risk – Even If It's Legal" campaign, jointly created by SAMHSA and the National Council on Patient Information and Education.

"Enhancing drug safety is an important step toward improving public health and reducing health care costs," writes SAMHSA.

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Connection Between Creativity, Depression And Addiction

It’s no secret that creativity and mental illness are intimately connected – the death of Robin Williams yesterday was, perhaps, a sad testament to that fact. Williams was arguably one of the best examples of both extraordinary creativity and the darker sides of that sort of genius: Severe depression and addiction. Among his many talents, Williams was famous for his capacity to draw striking and hilarious connections between subjects – and to flit back and forth between them – at mind-blowing speeds. A.O. Scott in The New York Times writes, “The only thing faster than his mouth was his mind, which was capable of breathtaking leaps of free-associative absurdity.”

So why are creativity – including comedy – and mental illness so intertwined? Like any creative profession – writer, musician, and artist – the answer may be that the comedian’s brain might be wired a little bit differently to begin with.

In interviews, Williams was quite open about his battles with cocaine and alcohol, which he famously gave up in the 1980s. He said in a People magazine interview in 1988, that cocaine “was a place to hide. Most people get hyper on coke. It slowed me down.” After being sober for more than 20 years, Williams relapsed into drinking in 2004 after his good friend Christopher Reeve, with whom he’d attended Julliard, died. He checked himself into an addiction facility in 2006 to help him with his alcohol addiction. In 2009, Williams had heart surgery, which is said to have affected him deeply. Earlier this year, he went back into treatment, to “finetune” his sobriety.

It’s hard to know what Williams’ internal dialogue was like, but it was undoubtedly a dark one at times. “You’re standing at a precipice and you look down, there’s a voice and it’s a little quiet voice that goes, ‘Jump,’” Williams said in an interview with Diane Sawyer in 2006. “The same voice that goes, ‘Just one.’ … And the idea of ‘just one’ for someone who has no tolerance for it, that’s not the possibility.”

The Dark Side of the Comedic Mind

That extreme darkness can lurk underneath the humor is another reality of comedians. A study earlier this year in the British Journal of Psychiatry found a strong connection between comedic prowess and, if not exactly psychosis, something close to it. The authors wanted to see if comedy fell into the same category of other forms of creativity, long thought to be either product of mental illness, or an escape from it. “Being creative – writing, composing, painting and being humorous – might therefore be an outlet,” they write, “an escape from the pain of depression. The poet and writer Antonin Artaud, who himself experienced serious mental illness, wrote, ‘No one has ever written, painted or sculpted, modeled, built or invented except literally to get out of hell.’”

The authors had 523 comedians from the U.S., Britain, and Australia, complete personality tests, and found a stronger likelihood for schizotypy – the propensity for psychotic personality traits, without full-blown psychosis – as well as traits that might blur into manic-depressive disorder. Most fascinating was that comedians, compared to regular old actors, had traits of both introverts and extroverts, which the authors say could “combine synergistically to facilitate comedic performance.”

Comedians’ brains are constantly combing their reservoir of knowledge to arrive at unexpected – and therefore comical – connections and commentary on life. One comedian in the study likened the comedic brain to a high-speed Google search: “Comedians train their brains to think in wide associative patterns. This relates to joke writing, where the word ‘bicycle’ brings up a picture of a bicycle in the mind of a non-comedian, but for the comedian it’s like running a search on the Internet—everything related pops up, from images of fat people riding bicycles naked and getting chafed to the fact that Lance Armstrong has only one testicle.”

Williams wasn’t the only comedian to discuss the dark dialogue within. The study also recalls the now-famous quote by Stephen Fry, host of the BBC quiz show QI. He talked candidly about his own moment-to-moment double-reality: “There are times when I’m doing QI and I’m going ‘ha ha, yeah, yeah,’ and inside I’m going ‘I want to fucking die. I… want… to… fucking… die.’”

For Williams, his demons were not so hidden, and many have pointed out that the sadness was visible in his crystal blue eyes. “Mr. Williams spoke about this himself,” says Constance Scharff, PhD, Senior Addiction Research Fellow and Director of Addiction Research, at California treatment center Cliffside Malibu. “He had spoken too about how sometimes it’s important to be funny when you’re speaking about really painful subjects. Humor can be a tool to obfuscate pain. How many comedians have we watched die from addiction (accidental overdose) or suicide? Sometimes people make us laugh so we can’t see how much they hurt.”

The Creative, Addictive Brain

The brains of some of us are undeniably, and genetically, predisposed to addiction. For high-powered businesspeople and “creatives” alike, there seems to be a particular tendency for chemical dependence. It’s not that the one leads to the other – simply that the traits coexist, perhaps sharing a fundamental wiring that ups the odds for both.

“I’ve read reports stating that about fifty-percent of addicts also have a co-occurring psychological disorder, such as depression or anxiety,” says Richard Taite, founder and CEO, Cliffside Malibu. “In our experience, the percentage is much higher. Around three out of four of our clients have issues with addiction and a co-occurring disorder. With the most creative individuals, we can expect co-occurring disorders in almost all of them.”

But again, one isn’t necessarily a cause for the other. And there’s something to be said for the highly-sensitive individual theory – that some of us may just be more in tune with the world, comedy and tragedy alike. “I don’t believe that artistic talent – and I mean this in the broadest sense of acting, music, writing, visual arts, dance, etc. – is causative of these problems of addiction, depression or suicidal thoughts,” says Taite. “Rather, I think that people who are creative have an empathy for and sensitivity to the world that allows them to feel things deeply. I believe Mr. Williams could deeply feel and experience the pain in the world, the pain in his life – and among those who orient toward depression – both creativity and addiction are ways out, ways to feel and to feel if not more hopeful, at least less sad.”

A Sad Ending to A Rich Life

Article after article will tell you that help could have been there for the 34,000 people who commit suicide each year. This is mostly true. The irony, of course, is that severe depression can prevent a person from believing that treatment could help.

“Unfortunately, when the pain becomes too much and seems as if it is without end, suicide looks to be a viable alternative to suffering,” says Taite. “For those who suffer from depression and have relapsed after a long period of recovery, it is imperative that quality treatment be immediately sought and suicide guarded against… The tragedy here is that there is quality, evidence-based treatment available and Mr. Williams did not receive it… One of the world’s bright lights has gone out.”

That said, Williams used his 63 years in some extraordinary and profound ways – to make us laugh and cry, and to reflect on and cherish life. His work in philanthropy was well known, and he seemed to want to give back all the gifts he’d been given, in life and in talent. Perhaps he said it best himself: “You’re only given one little spark of madness. You mustn’t lose it.”

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Depression Can Be Treated, But It Takes Competence

When the American artist Ralph Barton killed himself in 1931 he left behind a suicide note explaining why, in the midst of a seemingly good and full life, he had chosen to die.

“Everyone who has known me and who hears of this,” he wrote, “will have a different hypothesis to offer to explain why I did it.”

Most of the explanations, about problems in his life, would be completely wrong, he predicted. “I have had few real difficulties,” he said, and “more than my share of affection and appreciation.” Yet his work had become torture, and he had become, he felt, a cause of unhappiness to others. “I have run from wife to wife, from house to house, and from country to country, in a ridiculous effort to escape from myself,” he wrote. The reason he gave for his suicide was a lifelong “melancholia” worsening into “definite symptoms of manic-depressive insanity.”

Barton was correct about the reactions of others. It is often easier to account for a suicide by external causes like marital or work problems, physical illness, financial stress or trouble with the law than it is to attribute it to mental illness.

Certainly, stress is important and often interacts dangerously with depression. But the most important risk factor for suicide is mental illness, especially depression or bipolar disorder (also known as manic-depressive illness). When depression is accompanied by alcohol or drug abuse, which it commonly is, the risk of suicide increases perilously.

Suicidal depression involves a kind of pain and hopelessness that is impossible to describe — and I have tried. I teach in psychiatry and have written about my bipolar illness, but words struggle to do justice to it. How can you say what it feels like to go from being someone who loves life to wishing only to die?

Suicidal depression is a state of cold, agitated horror and relentless despair. The things that you most love in life leach away. Everything is an effort, all day and throughout the night. There is no hope, no point, no nothing.

The burden you know yourself to be to others is intolerable. So, too, is the agitation from the mania that may simmer within a depression. There is no way out and an endless road ahead. When someone is in this state, suicide can seem a bad choice but the only one.

It has been a long time since I have known suicidal depression. I am one of millions who have been treated for depression and gotten well; I was lucky enough to have a psychiatrist well versed in using lithium and knowledgeable about my illness, and who was also an excellent psychotherapist.

This is not, unfortunately, everyone’s experience. Many different professionals treat depression, including family practitioners, internists and gynecologists, as well as psychiatrists, psychologists, nurses and social workers. This results in wildly different levels of competence. Many who treat depression are not well trained in the distinction among types of depression. There is no common standard for education about diagnosis.

Distinguishing between bipolar depression and major depressive disorder, for example, can be difficult, and mistakes are common. Misdiagnosis can be lethal. Medications that work well for some forms of depression induce agitation in others. We expect well-informed treatment for cancer or heart disease; it matters no less for depression.

We know, for instance, that lithium greatly decreases the risk of suicide in patients with mood disorders like bipolar illness, yet it is too often a drug of last resort. We know, too, that medication combined with psychotherapy is generally more effective for moderate to severe depression than either treatment alone. Yet many clinicians continue to pitch their tents exclusively in either the psychopharmacology or the psychotherapy camp. And we know that many people who have suicidal depression will respond well to electroconvulsive therapy (ECT), yet prejudice against the treatment, rather than science, holds sway in many hospitals and clinical practices.

Severely depressed patients, and their family members when possible, should be involved in discussions about suicide. Depression usually dulls the ability to think and remember, so patients should be given written information about their illness and treatment, and about symptoms of particular concern for suicide risk — like agitation, sleeplessness and impulsiveness. Once a suicidally depressed patient has recovered, it is valuable for the doctor, patient and family members to discuss what was helpful in the treatment and what should be done if the person becomes suicidal again.

People who are depressed are not always easy to be with, or to communicate with — depression, irritability and hopelessness can be contagious — so making plans when a patient is well is best. An advance directive that specifies wishes for future treatment and legal arrangements can be helpful. I have one, which specifies, for instance, that I consent to ECT if my doctor and my husband, who is also a physician, think that is the best course of treatment.

Because I teach and write about depression and bipolar illness, I am often asked what is the most important factor in treating bipolar disorder. My answer is competence. Empathy is important, but competence is essential.

I was fortunate that my psychiatrist had both. It was a long trip back to life after nearly dying from a suicide attempt, but he was with me, indeed ahead of me, every slow step of the way.

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Women And Insomnia

Women are more likely than men to experience insomnia. A 2005 National Sleep Foundation poll found that 57% of women and 51% of men said they experienced a symptom of insomnia at least a few nights per week. Unfortunately, only seven percent of women reported receiving treatment for insomnia, according to a separate National Sleep Foundation poll.

Certain phases of the menstrual cycle, pregnancy, and menopause can all contribute uniquely to women’s sleep troubles. Sometimes, these biological changes disrupt sleep, but then unhealthy sleep habits maintain the pattern.

This is why keeping good sleep practices is important for women. In addition to general sleep hygiene recommendations, there are many steps that can improve your sleep.

If your insomnia is caused by hormonal fluctuations and hot flashes, keep your room temperature cool and comfortable, and have a glass of water, a change of pajamas and an extra pillowcase by the bed if you sweat during the night.

For insomnia during pregnancy, keep multiple pillows on hand during the night. Try sleeping on your side with one pillow at your back, one between your legs, and one to rest your arms on. Limit your fluid intake during the evening.

For many women, insomnia is linked with depression. Relaxation exercises can help, but it’s important to see your doctor or a psychotherapist to address these symptoms as well. There are both medical and non-medical treatment options for insomnia.

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Children With Autism In Medication-Related Weight Gain Study

Vanderbilt University is one of four sites in the United States and Canada to enroll children with autism in a study to examine weight gain commonly experienced while taking antipsychotic medication.

Medications prescribed in up to 20 percent of children with autism, including Risperdal, Abilify, Seroquel and Zyprexa, often cause substantial weight gain and put children at greater risk for developing diabetes.

This new study will examine if the investigational drug metformin is safe and helpful in reducing weight gain for children with autism who are taking anti-psychotic medication.

“Right now, parents are placed in the difficult position of deciding between their children’s physical health or losing the beneficial effects of the medication on behavior,” said Kevin Sanders, M.D., assistant professor of Psychiatry and Pediatrics and Medical Director of the Treatment and Research Institute for Autism Spectrum Disorders at Vanderbilt. “This is a critical study that has the potential to improve the lives of children with autism, a disorder that now affects an estimated one in 68 children.”

Recent studies have shown metformin to be the most effective approach to weight gain in adults and is a medication most commonly used to treat diabetes. While metformin has been studied in adults, there is limited information on its effectiveness in children, and it has never been studied in children with autism, who often respond differently to medication.

Participants in this study will receive treatment at no cost.

To participate in this study, contact Sarah Marler, M.A., at (615) 936-3288 or This email address is being protected from spambots. You need JavaScript enabled to view it. .

This study is funded by the Health Resources and Services Administration as part of the Autism Intervention Research Network Physical Health. Other study sites include Nationwide Children’s Hospital at Ohio State University, University of Pittsburgh and Holland Bloorview Kids Rehabilitation Hospital at the University of Toronto.

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Treatment: Web Therapy Could Be An Option For Bipolar Disorder

An online platform that helps people with bipolar disorder self-administer therapy has proven to be successful in a small trial, with 92 percent of participants saying they found the content positive.

Nicholas Todd, a psychologist in clinical training at the NHS Trust, has developed the site as part of a project he's running called Living with Bipolar.

In it, he asked 122 people to use a sort of e-learning environment that uses audiovisual models and worksheets, incorporating parts of cognitive behavioral therapy and psycho-education known to be effective in bipolar patients. There's also a peer support forum, which is moderated by a member of Todd's research team, and motivational emails were periodically sent to those on the trial.

"Service users were encouraged to access the intervention flexibly and use it as and when they felt appropriate," Todd told Wired.co.uk. That's because, as he presents in a paper on the platform, for patients "recovery is defined as people living a fulfilling life alongside their condition". As such, it needs to fit in around them, their lifestyle and their changing needs.

One participant comments: "....for me recovery is certainly not about being symptom free… it is about coping and having a reasonable quality of life, being able to work productively and enjoy things outside of work."

Thus, Todd explains, "service users did not focus on a 'cure' as their desired outcome but instead personally defined recovery goals and improved quality of life."

By the trial end, Todd found that on average, users who stayed till the end completed 60 percent of the program. Of the people that completed the whole thing -- 15 modules -- 74 percent took under three months to do so.

The platform took a year to develop, spent looking at the most effective components of psychological therapy for bipolar disorder. As this was narrowed down, the group carried out five focus groups and tested it online via a consultancy group.

The system gets users to identify their own mood using an established scale, the idea being they -- and the system -- can track their own ups and downs. "Service users would then receive information about the most appropriate modules, given their mood symptoms," says Todd.

The forum, he says, played a key role in the project's success. One participant commented, "...part of it [bipolar disorder] is feeling very alone... you don't get that and I do think that the forum works extremely well with the intervention..." Todd explains how participants used it to support each other not only through the new intervention process, but through life events.

"A balance was struck between allowing participants to offload, and posts which encourage or talk about acts of suicide, self-harm, harm to others and are unhelpful to participants' recovery." A total of 70 percent of the users signed up to the forum, and 1,927 posts on 130 topics were accumulated. "The participants who used the forum tended to complete more modules, and all participants who completed the entire program used the forum, albeit in different ways."

The idea behind the platform is to help bridge those periods between appointments, or those appointments that a patient misses. As with depression, health services can be known to administer solely medication to help alleviate symptoms. More and more, the NHS is striving to ensure psychological therapy is integrated alongside a prescription for mood stabilizers, such as lithium. "However, severe inequalities in access to psychological interventions for bipolar disorder currently exist in the NHS," Todd says. "This intervention aims to increase access to psychological intervention."

Todd tells us the NHS is actively training more staff to deliver psychological therapy, to plug the gap. For now, that initiative is being piloted for severe mental health conditions. "This intervention may fit as part of this initiative in giving service users with bipolar disorder greater access to psychological therapy.

"Computerized interventions are not about replacing face-to-face interventions, but giving someone another option to receive psychological support. In fact, some people prefer accessing psychological support in this way as it fits better with their lives."

For one woman in particular the experience has been, in her words, "life changing".

She said: "I have encountered insights in the modules that have significantly helped me to survive the blackest moments. I cannot measure the value of this, as it has contributed to their difference between life and death. My husband and I are sincerely grateful for the immeasurable impact this has had on our family."

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Online Cognitive Behavior Therapy Effective In Treating Health Anxiety, Study

Online cognitive behavior therapy is more effective in treating health anxiety than active psychological treatments involving relaxation and stress management therapies, according to a new study by the Karolinska Institutet, Sweden.

The researchers said that health anxiety, also known as hypochondria, can be described as a strong, persistent and excessive fear of succumbing to serious illness. Patients suffering from this anxiety disorder experience chest pain or headaches that are often perceived to be some serious disease.

The medical condition causing distress often occurs among patients within primary care and due to mental illness like depression.

The cognitive behavior therapy via Internet involves gradual exposure to situations that may activate health anxiety.

For the first time, the researchers subjected 158 participants to both internet and psychological treatment for 12 weeks. The participants had access to therapists via e-mail.

The researchers said that the participants found both the treatments to be equally reliable in reducing their anxiety. But, the exposure-based treatment lowered health anxiety to a greater extent than the treatment focused on relaxation and stress management.

"More people can be treated since the treatment time per patient is significantly lower as compared to that of traditional treatment. Internet treatment is independent of physical distance and, in time, this means that treatment can be administered to people who live in rural areas or in places where there is no outpatient psychiatry with access to psychologists with CBT expertise," said licensed psychologist Erik Hedman, who led the study, in a statement.

The finding is published in the British Journal of Psychiatry.

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Opinion: There Is No One Root Cause Of Depression

The unexpected death of actor and comedian Robin Williams of an apparent suicide has many talking about the roots of depression, but the chair of the psychiatry department at the University of Rochester said Tuesday there is no one cause.

Some are finding it difficult to believe Williams took his own life, as he was one that always seemed full of life, energy and humor.

"It's shocking especially when we see someone like Robin Williams who for us was uplifting, a source of joy, humor, distraction and all those other things, and to think how come he couldn't do that for himself at that moment? That's almost unanswerable," said Dr. Eric Caine.

Caine chairs the psychiatry department at the U of R and is co-director of the Center for the Study and Prevention of Suicide. He said many times people use humor as a crutch and a way to hide the empty feeling they have inside.

"Finding a way to lighten the burden is always something we use humor for," Caine said. "Even in the dark moments, it might be ironic or sarcastic, but we use humor as a way of changing the tone, changing the mood and it's a good thing. It's a way of playing, and even in the midst of a bad time we try to find some way and that's why we talk about gallows humor or dark humor, and it's a protection."

Caine said suicide is the tenth leading cause of death in the United States. Twice as many people in this country die from suicide than homicide and it's more common among men.

Caine said there are no common warning signs for depression and suicide, as it depends on the individual. Caine said everyone deals with it differently and Williams may have covered any signs of depression through his comedy.

"I don't really try to say 'who's the person who's likely to die,' I try to say 'who's the person I really think needs help,'" Caine said. "That's going to make me error on the side of helping more than those who are most likely to die, but that's fine, they still need help.

So we don't need to be the person with the magic needle detector in the haystack, what we need to do is say look, there's a bunch of people that need help, let's help them all, let's find a way of getting services to them, let's find a way of reaching out and supporting them and in the process we may affect someone's life."

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Did You Know?

New studies find that chronic pain and phobic anxiety are linked with shorter telomeres

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