The patients were randomly assigned to a combination of sertraline, an anti-depressant, and either omega-3s or a corn oil placebo. After 10 weeks, there was “absolutely no difference” in depression remission rates between the 59 patients taking omega-3s and the 56 patients taking the placebo, said Robert M. Carney, lead author of the study, which appeared in the Oct. 21 issue of the Journal of the American Medical Association.

“It was very disappointing,” he said.

The trial was launched because patients with heart disease are at greater risk of dying if they are depressed, Dr. Carney said. Depressed patients are known to have low levels of omega-3s, which are a risk factor for heart disease, as well.

Now, with any study, there are multitudinous caveats. It’s a small sample. They had lower levels of omega-3s to begin with. Perhaps there were other factors (i.e., physical illness) that superseded the treatment of depression, yadda yadda.

And there has been other research to suggest omega-3s are useful for depression. USA Today broke down a different study in 2007:

The omega-3 fatty acid in some fish may be a “brain food” that helps ward off depression because it increases gray matter in three areas that tend to be smaller in people who have serious depression, a study suggests today.
The increase could help explain why past studies have found that the omega-3 acid DHA reduces symptoms of depression. The richest sources of DHA are fatty fish and fish-oil capsules.

Researchers gave magnetic resonance imaging tests to 55 adults. Participants also reported everything they ate for 24 hours on two randomly selected days, says study leader Sarah Conklin, a neuroscientist at University of Pittsburgh Medical School. She’ll report her findings at the American Psychosomatic Society meeting in Budapest.

The more DHA a person consumed, the more gray matter there was in three areas of the brain linked to mood: the amygdala, the hippocampus and the cingulate, Conklin says. Seriously depressed people tend to have less gray matter in these areas, she says.

For every yes in research, there’s a no. It’s really frustrating for people looking for answers. That’s why it’s best to just go with your gut: Try what feels right and if it works for you, great. If it doesn’t work for you, move on to something else. But remember: There is no magic bullet — oily or otherwise.

As I’ve written and spoken about before, my sister suffers from a bipolar disorder and my nephew from schizoaffective disorder. There has, in fact, been a lot of depression and alcoholism in my family and, traditionally, no one ever spoke about it. It just wasn’t done. The stigma is toxic. And, like millions of others who live with mental illness in their families, I’ve seen what they endure: the struggle of just getting through the day, and the hurt caused every time someone casually describes someone as “crazy,” “nuts,” or “psycho”.

What’s remarkable is not her frankness about this personal history, but her motivation to act, which seems almost like a wholesale rethinking of her career and what it’s meant in popular culture. In Fatal Attraction, for example, she played a woman obsessed with Michael Douglas (those were the days, right Michael?). She loses control of the obsession and becomes terrifying. As Close writes, the movie was a great success, and audiences loved to hate her character.

Alex Forrest is considered by most people to be evil incarnate. People still come up to me saying how much she terrified them. Yet in my research into her behavior, I only ended up empathizing with her. She was a human being in great psychological pain who definitely needed meds. I consulted with several psychiatrists to better understand the “whys” of what she did and learned that she was far more dangerous to herself than to others.

The original ending of Fatal Attraction actually had Alex commit suicide. But that didn’t “test” well. Alex had terrified the audiences and they wanted her punished for it. A tortured and self-destructive Alex was too upsetting. She had to be blown away.

So, we went back and shot the now famous bathroom scene. A knife was put into Alex’s hand, making her a dangerous psychopath. When the wife shot her in self-defense, the audience was given catharsis through bloodshed — Alex’s blood. And everyone felt safe again.

The ending worked. It was thrilling and the movie was a big hit. But it sent a misleading message about the reality of mental illness.

This is a bold admission from a woman who derived so much success from this role, but there’s no escaping what she says. It has long bothered me — and, I suspect, other advocates — that the message there is one of terror and fear.

Not only does Close take on her role in that film, she assesses the entertainment industry as a whole:

Whether it is Norman Bates in Psycho, Jack Torrance in The Shining, or Kathy Bates’ portrayal of Annie Wilkes in Misery, scriptwriters invariably tell us that the mentally ill are dangerous threats who must be contained, if not destroyed. It makes for thrilling entertainment.

There are some notable exceptions, of course — Dustin Hoffman in Rainman, or Russell Crowe’s portrayal of John Nash in A Beautiful Mind. But more often than not, the movie or TV version of someone suffering from a mental disorder is a sociopath who must be stopped.

I like to think that her speaking out will change this. As she so eloquently says, silence is the problem. Read more of her elegant prose here. It is well worth it. There you’ll find links to the initiative she’s promoting.

Thank you, Glenn, for speaking out against silence. You rock.

The Cause of Ted Kennedy’s Life

Patrick, my condolences on your father’s passing. When your dad’s brothers died, he had to get himself together and stop being an irresponsible, drunken frat boy. He had to become a leader who espoused what they did: social justice, pacifism, equal rights, etc. You have a head start: You made mental health parity happen, and you’ve been engaged in fighting the good fight since the beginning. You’re my hero.

But I also know you’re flawed and troubled, like your dad was, like we all are. The politicians who pretend to be saints tend to fail us, so you just go on being imperfect. And if you need support in your time of grief, just think of us out here, rooting for you to do well. We support you because you’re our voice now. And because we know what it’s like to live with loss. We believe in you. Carry on.

Madigan: They didn’t flatter you with that lighting.

David Oaks: You’re looking so handsome! I had no idea. Your eyebrows are very sexy. (I’m completely sincere.)

“But critics worry …” That’s journalism-speak for “We don’t have any specific sources who say this, but we’ll generalize it so we have reason to focus on …”

… violence. That’s what they’re focusing on. Why am I not surprised?

So of all the things they could talk about related to Mad Pride — and related to mental health — this is what they’ve come up with: criminals and violent crime. Ugh. TV is so predictable and depressing.

Okay, so now we’re telling the story of a kid with hallucinations and delusions (the CIA, yadda yadda) who KILLS HIS MOTHER? Does the average American viewer understand how fucking rare this kind of thing is? That it’s not the necessary result of deciding not to take meds?

On to the withdrawal story: Clearly, the program wasn’t looking for a success story. This poor woman who decided to do the show so they could feed off her misery — I knew that’s what they wanted. Is she doing the withdrawal in conjunction with a doctor? Who the hell knows? The show doesn’t tell you. It hardly tells you her name. And …

Oh! There it is again: “Critics worry … ” (that she’s going to be “a time bomb” without her meds). Who are these critics worrying about this girl? Frank Rich? David Denby? I’d love to know.

“Violence is unpredictable with or without drugs.” Brilliant script.

Blurry homeless images. Madigan cello-ing. … This show is so bad, it’s like a joke. I guess it all goes back to what producer Ia Robinson told me, when we discussed my being on the show: She doesn’t have any friends or family who have mental problems, so the whole topic was like “walking on the moon.” Yes, that’s the phrase she used. The show should’ve been blasted out to Mars.

Except Joey P. He’s delightful and a voice of reason.

To get a sense of what it’s going to be about, go here for the article, which offers an online video interview with Joe Pantoliano, who’s featured in the story. (Full disclosure: I was interviewed for the show, but I don’t think I’ll be mentioned.) On the page with Pantoliano’s story, there’s a poll: “Should people with mental illnesses be required to take medication?” Now, why the hell would that be the question related to this piece? Here are the potential answers:

No. It should be a patient’s choice whether or not to accept medication.
72%

Yes. When people refuse to take medications, it can be dangerous.
28%

I’m distressed that even 28 percent would agree to that fatuous statement. But then again, that’s a big focus of the piece that’s online right now: whether Mad Pride is “safe.” I’m not going to comment further until I see the TV show; maybe that false dichotomy — Mad Pride vs. taking meds — won’t be the setup. I hope not, because it’s really kind of stupid.

There’s a prickly debate going on over at Psych Central on the subject of the MOTHERS Act, which, rather unexcitingly, suggests pregnant moms get screened for postpartum depression — something that’s rather standard in the UK and Australia. There is opposition to the Act, as embodied in a post by J. Douglas Bremner, psychiatrist and author, who believes the act stigmatizes motherhood. He quotes Amy Philo, who had a terrible experience after being misdiagnosed with PPD (and who was featured in a recent article in Time about the Act).

John Grohol wrote a response to Bremner’s assertions about the Act and about PPD in general. His response has caused a bit of a furor over there. In broad strokes, I agree with Grohol and endorse his position — which will have the Scientologists among you lashing out against me. But there does have to be a check embedded in the legislation so that medication is the last treatment prescribed rather than the first. And OB/GYNs should not be prescribing psych meds on their own but only in consultation with a psychiatrist. There are already too many scrips flying out of the hands of the wrong people.

It’s interesting that the issue of screening is rather uncontroversial in other countries. I wonder what that says about us. And about Scientology.

Grohol has been responding thoughtfully to all his commenters, which is why he has more patience than I do. I always get overwhelmed at the thought of doing that, so I retreat into a box of cereal or something. Tally-ho, John!

Friends of the King of Pop have claimed that he “often overdosed” and had been trying to kill himself for a decade. One said: “We’re surprised he even made it to 50”.

The Daily Star reported that insiders believe the financially struggling star “couldn’t face his problems” and wanted a way out.

He would keep the suicide note in his pocket and overdosed, they told the newspaper. “Michael always talked about dying young,” one said. “He wrote suicide notes then tore them up. He kept one with him – he often read it.

“He wanted everyone to know how sad he was.” Another friend told the newspaper that Jackson had wanted to end his life ever since he was humiliated by child abuse claims in the 1990s.

That’s quite sad.

Michael Jackson Kept Suicide Note

We’ll all miss Steven so much, and I’ll say more about that later. For now, I’m wishing the best to all family and friends who are hurting. That’s what Steven really cared about in the end, though he was very passionately annoyed by knitting, as well.

Steven was often told he was anti-American. I loved his passion, and he cracked us the fuck up every day. This video was part of a series he did for PW called Steven Wells’ America, in which he took sacred cows and basically grilled them for dinner. Below, he reflects on the religiosity of an America that voted for Bush a second time (Steven was a staunch atheist). Toward the end he smiles a bit, so you know that he knows he’s being ridiculous. And that’s part of what was so cute about Steven — he’d rant, but then laugh at himself.

I am just tired. Tired of feeling ill from my meds 24/7. Tired of being too sick to work. Tired of not having any money and applying for food stamps and subsidized housing.

Tired in the fact the one trip to the city I took since 07 cause I didn’t have the money to go= I get comped two tickets for “Next to Normal”, and it triggers every trigger I have in the universe. I haven’t been the same since i saw the play.

Other than underwear, I have not bought any new clothes since 07. I have not gone anywhere, unless you count Princeton and New Brunswick. I don’t.

Living in the burbs where it’s all families and young marrieds commuting into the city- it sucks, I should be in a city- any city somewhere. Not here. Please not here.

All I ever wanted from the time I graduated from college was to be a wife and mother. The ex said he wanted children, after we married I found out he didn’t. Hence the annullment. I would have never married him if he had told the truth.

All I have at this point of my life, are broken dreams. I don’t have any dreams now.

I spend my days popping pills to sleep 18 -20 hours a day so I can be as close to death as I can without actually being dead. I have a blog which got some awards but no one visits. All I know how to do is write. And I wonder if I can every really do that.

All I know, I just want to be somewhere else before my birthday. That’s it. I just don’t know how to get there.

The cat will be fine. AK or Peter will take care of her. I am not fine. I need a dream, or a dirt nap.

Now, team, this is your assignment: Go to Susan’s blog and leave her a comforting comment. We have all been where she is now, and it’s not a good place to be. And the idea that someone else could care for kitty Holly? Ridiculous. No one loves Holly or understands her like Susan.

My life would be so much less meaningful without Susan. She has supported me and encouraged me in dark times. She has been an admirer and friend. And yes, she’s a kick-ass writer. We love you, Susan!

It was the private voicemail message not meant to be shared and yet ended up being heard by nearly everyone – Alec Baldwin’s angry April 2007 tirade against his daughter, Ireland, accusing the then-11-year-old of being a “rude little pig” who needed to have her “ass straightened out” after she had “humiliated me for the last time.”

Only now, as the Emmy-winning 30 Rock star admits in a candid interview with Playboy for its July/August issue (on newsstands and online Friday), after the phone message was exposed, he contemplated killing himself.

…

Describing his thoughts of killing himself as “very serious,” Baldwin, 51, says, “I spoke to a lot of professionals, who helped me … If I committed suicide, [Kim Basinger's side] would have considered that a victory. Destroying me was their avowed goal.”

His self-destructive state of mind was such, recalls Baldwin, that he also offered to quit 30 Rock and actually went ahead and – briefly – dropped his agent, who also represented Basinger.

I find him quite delightful, personally.

Alec Baldwin Was Suicidal over Angry Voicemail to Daughter

Shares of Clinical Data Inc. (CLDA) rose after the last late-stage study on its treatment for major depressive disorder achieved the targets for efficacy and tolerance, clearing the way for the treatment’s new drug application to be filed later this year.

The biotechnology company jumped as much 14% Tuesday morning after saying its treatment, vilazodone, was generally well tolerated …

But the study also showed high rates of some side-effects, including diarrhea and nausea.

…

Biologic Investment Research analyst Kevin McNamara didn’t think the study was positive at all. He pointed to the high amount of patients who suffered from diarrhea – 31% – and nausea – 26% – saying the effectiveness of the treatment wouldn’t set it apart from the field.

“The incidence of diarrhea is outrageous, that’s the only groundbreaking thing about this study,” McNamara said. “There just is not another place in the market [for vilazodone].”

…

Clinical Data, which wasn’t immediately available for comment, pointed out in its release that only one patient out of 240 left the study because of diarrhea while three quit because of nausea.

And with two positive Phase III studies now in the books, Clinical Data says it should file its new drug application for vilazodone by the end of the year.

Clinical Data Rises On Study Results For New Antidepressant

Explanation:

A package of bills sponsored by Senate President Richard J. Codey that are designed to protect patient safety and improve employee training and oversight at state psychiatric hospitals was approved yesterday by the Senate Health, Human Services and Senior Citizens Committee. … Sen. Codey worked closely with the Public Advocate’s office in drafting these bills, in part, to address a number of injuries and deaths that had arisen recently at state facilities such as Ancora Psychiatric Hospital.
Bill S2492, would require the Department of Human Services (DHS) to establish a training program for staff members who work directly with patients at state psychiatric hospitals in order to ensure the delivery of safe, secure, and therapeutic care.  Utilizing best practices in patient treatment, the curriculum would include topics such as state and federal reporting requirements, patient safety, disease prevention, health wellness activities, anger management, skilled decision-making and how to deal effectively with life-threatening emergencies. … The bill would require DHS to establish an on-site educational assessment and remedial instruction program at each state psychiatric hospital in order to evaluate the proficiency of all staff members who work directly with patients.

The bill would also require the commissioner of DHS to establish minimum educational standards for staff members at a hospital who work or will work directly with patients. … Employees already working directly with patients at the time of the bill’s enactment would be required to undergo an evaluation to determine if they meet the educational standards or require remedial instruction through the on-site education program.Any employee that refuses to participate in the training program or fails to meet the educational standards and refuses to participate in remedial instruction, would be terminated from employment at the hospital. …

The second bill, S2493, would require current and future employees of state psychiatric hospitals, developmental centers and veterans’ memorial homes to undergo drug testing for controlled dangerous substances as a condition of employment.

The last bill in the package, S2494, would require DHS to report the number of physical assaults and deaths that occur at state psychiatric hospitals. The report would be a public record, posted on the official DHS website, and updated quarterly, but would not contain any identifying information about patients or staff members.

As a longtime fan of Sen. Codey’s commitment to mental health matters, I do think it’s a good move. But is it transformative? As an astute TTWS reader notes:

It’s hard to see how these three bills alone will transform patient care at New Jersey’s state psychiatric hospitals which includes Ancora, let alone insure the care long required by law, New Jersey Statutes Annotated 30:4-27.1(c), It is the policy of this State that persons in the public mental health system receive inpatient treatment and rehabilitation services in accordance with the highest professional standards and which will enable those hospitalized persons to return to their community as soon as it is clinically appropriate.

Too often words and deeds fail to intersect at our nation’s psychiatric hospitals. Transform and its variants are now used so frequently that any change is considered transformative. More recently at another New Jersey state psychiatric hospital where a new building was going to lead to transformation (click here, paragraph 5), the reality belied the representations, ex. Developing therapeutic alliances between patients and staff remains a challenge, with differences in race, ethnicity, social class and education creating a ‘them versus us’ scenario.

“When I use a word it means just what I choose it to mean — neither more nor less.” Humpty Dumpty

The Eagles’ (<3) Shawn Andrews has been very open about his struggle with clinical depression, which I greatly admire in a lineman. The New York Times is apparently all over the pro sports/mental health beat (thanks to Dave K. for letting me know):

Andrews said he had seen a psychiatrist last summer in Little Rock, and then in Philadelphia, but that he was not currently undergoing counseling. He did say he was taking antidepressant medication, along with the drug Adderall to treat attention-deficit disorder.

He said he understood that some people had little sympathy for a highly paid professional athlete, that even some of his teammates might feel he was exaggerating, or using depression as an excuse for an indifference to football. “That’s fine,” he said. “I don’t work for them. They don’t pay my bills. They don’t take care of my family.”

He said he took gratification from a handful of players around the league who told him they felt similarly and from others who said they had been emboldened by his own admission.

“A lot of people say football should help you channel your anger and aggression,” Andrews said. “But it’s not as easy as people think it is.”

…

Compared with last year, Andrews said, “I’m at a better point, mentally and physically.”

Early last August, as rumors grew about his absence, Andrews told reporters that he was suffering from depression, had sought professional help and was taking medication. He eventually reported to the team, but played in only two games before sustaining a herniated disk in his back, which required surgery.

For a brief period last season, he said he stopped taking his medication.

“I was feeling great, I was like, this thing is over,” Andrews said. “Man, things went south. I’ve never been a big fan of medication, but at this point it’s very crucial for me.”

So far this off-season, [coach Andy] Reid said, Andrews is “doing a great job.” Andrews said the move to tackle could rejuvenate his career.

Still, his renewed enthusiasm has been tempered by the fact that he has missed nearly two full seasons to injury.

“All the physical anguish I’ve been through, the thought of not being able to get up and play with my son, that really keeps my mind going every day,” Andrews said.

He sees some of his teammates dropping items and struggling to bend and pick them up.

“I don’t want to live like that,” Andrews said.

Inside Lineman’s Helmet, Doubts and Depression

Today I found a double whammy: an article about the recession and resultant depression, which is not only concordant in terms of themes, but also rhymes. The major mental health charity organization in Britain, Mind, released a study that says that men are more prone than women to recession-related blues. Yet men are less likely to tell someone about it and get help. From BBC.com:

Paul Farmer, chief executive at Mind, said: “The recession is clearly having a detrimental impact on the nation’s mental health, but men in particular are struggling with the emotional impact.

“Being a breadwinner is something that is still crucial to the male psyche so if a man loses his job he loses a large part of his identity putting his mental wellbeing in jeopardy.

“The problem is that too many men wrongly believe that admitting mental distress makes them weak and this kind of self stigma can cost lives.”

Stephen Fry, our beloved, is supporting Mind’s campaign to educate men. One thing that’s notably different in Britain: the admirable insistence on therapy. Peter Cooper, of the British Psychological Society, was quoted as saying: “The type of help that men need includes psychotherapy but what they are also desperate for is pragmatic practical help.”

No mention of meds. Jolly well done.

Men ’suffering recession blues’

Not so with Effexor. I don’t even have to wonder if I’ve taken it; my body alerts me quite readily. I get really dizzy and spacey, and if I let it go till the next day, I’m essentially dysfunctional — half-asleep, half just an idiot. I’ve heard plenty of anecdotal stuff about “brain zaps,” and I’ve never had a problem with that. Just vertigo, mostly. But it’s enough discomfort that I can’t be without it. I feel like it controls me too much. It reminds me of my addiction days.

So, though I thought it helped me a couple years ago, I think I’ll move on. And if I get too depressed, I’ll just eat more candy. Um, yeah.

Doesn’t sound implausible to me, but we have to be careful. The cause and effect here isn’t clear. (It’s a puzzler, hence the image. Oy.) USA Today — best known these days as the paper that clutters your hotel-room doorway — has an article about study results from the May issue of the American Journal of Public Health. Some excerpts:

There is evidence that racial discrimination increases the odds that adolescents and adults will develop mental health problems, but this is the first study to examine a possible link in children of varied races, says Tumaini Coker, the study co-author and a RAND Corp. researcher and UCLA pediatrician.

It does not prove that discrimination caused the emotional problems, because unlike studies of older people, these children weren’t followed over time. It’s possible that prejudice harms children’s mental health, but it is also possible that troubled kids prompt more discriminatory remarks from peers or that children with emotional problems perceive more bias, says study leader Mark Schuster, a Harvard pediatrician and pediatrics chief at Children’s Hospital Boston.

The link between perceived racism and mental disorders is strong, he adds. For example, Hispanics who report racism are more than three times as likely as other children to have symptoms of depression; blacks are more than twice as likely; and those of “other” minority races have almost quadruple the odds.

Hispanics had the worst mental health effects, the study shows; perceptions of bias significantly increased their symptoms of all four disorders. About four out of five Hispanic children who felt prejudice had foreign-born parents. Black parents may buffer their children better, perhaps preparing them to expect some racism, Schuster speculates.

The study asked students whether they “ever” experienced racism, and that raises a question, says Rebecca Bigler, a University of Texas psychologist. In other research, children who report racism consistently say it rarely happens, she says. “We don’t know if it was a rare occurrence with these kids. Maybe it only has to happen once to be devastating if you’re young.”

Don’t answer that. I got an email from Maiken Scott, behavioral health reporter for WHYY, the PBS affiliate in Philly. She wrote:

Last year, I met with Dr. John O’Reardon, a U Penn scientist who invited me to cover a new treatment for severe depression as it develops and undergoes scientific testing. This approach is called DBS, or Deep Brain Stimulation. It is already being used successfully in the treatment of symptoms associated with Parkinson’s Disease. Dr. O’Reardon is passionate about helping people with treatment-resistant depression, and he cares deeply about his patients. Yesterday, I was in the OR at Pennsylvania Hospital, and watched the procedure. I had previously met with the patient. Her name is Tara, she is 50 and has suffered with depression for almost 40 years – we spoke at length before her surgery. I have started to file stories and we’re covering this as it develops both on air and on the web. I plan to follow her for the rest of the year, as she recovers and as scientists learn whether this treatment will bring her relief.

Sounds very interesting to me, and Maiken is a really good reporter. Check it out here.

What made me angry is that I know plenty of incompetent drivers who shouldn’t be on the road, and they don’t suffer from mental illness. I also know drivers who have severe mental illnesses who acquit themselves quite admirably on the roadways (myself included). It’s a violation, in my opinion, of a person’s civil rights to prevent them from applying to get a license.

One woman who did get approval was empowered by it. She failed the permit test again and again, but it never ceased to be a goal, which fit in with the messages given by the community health center: Make sure the clients set goals for themselves; it gives them hope. Perhaps it was an unrealistic goal for her. I don’t think she’ll ever drive. But it was the trying that mattered, and if she ever gets behind the wheel, I hope she drives far away into the sunset with a great song on the radio. Just for fun.

A Guy, a Car: Beyond Schizophrenia by Ronald Pies M.D.

But there is power in numbers. So I’m going to suggest that those in the Philadelphia area think about reaching out. From Craigslist:

There is a group that meets every Tuesday from 7pm to 9pm at the Belmont Center for Comprehensive Treatment located at 4200 Monument Rd, Philadelphia, 19131 (near the intersection of Ford and Monument Rd 1.0 miles from City Ave and Monument Rd). People who suffer from Depression or Bipolar Disorder are encouraged to attend these self help meetings. The group also offers care and share sessions for family and friends of those with Depression or Bipolar Disorder. For more information you can call Belmont at 215-581-3887 or contact Jerry at yeli647@yahoo.com.

It’s really worth going.

Let’s keep adding more tips.