Can Brain Imaging Aid Diagnosis of Mental Illness? (mobile format)

http://www.medscape.com/viewarticle/767822 According to this article, SPECT scanning lead to a complete change of treatment plan in 57% of patients scanned. Why is this not routine? More later on this topic, dear readers.

Copyright 2012 Laura P. Schulman all rights reserved

Serial Rapist in the US Air Force gets a slap on the hand

http://m.cbsnews.com/fullstory.rbml?catid=57477281&feed_id=1&videofeed=null This horrific sexual predator who preyed upon female recruits was convicted on 28 counts of first-degree rape and other forms of sexual harrassment and misconduct, while in the position of instructor to the women he abused. And yet, even though the law provides for up to life imprisonment for these crimes, he got 20 years. Usually that sentence carries a provision for parole in 7 to 10 years, dependent upon conduct. It is well known that sexual predators have a very high rate of recidivism. The probability that someone who has made rape his lifestyle, as this slimy worm has, will rape again when he gets out of prison, is unacceptably certain. His “heartfelt pleas” to the judge and jury that he be allowed to participate in his childrens’ rearing should have been taken as incentive to lock him up for life plus 20 years. What fine values could a monster like this instill into his children. Makes me want to vomit.

Copyright 2012 Laura P. Schulman all rights reserved

Moving, moving, always moving

I’m moving house again.  Well, not really house, as one generally thinks of a house.  It’s a sheltered space, yes, and it even has a brand new deck overlooking a rushing river.  What it does not have is a bathroom, or a kitchen, or a bedroom, or a closet.

It is the shell of my father’s ceramics studio, that he is no longer capable of working in.  I have spent most of a year making it structurally sound: decontaminating it of poisonous chemicals (lead and other heavy metals, solvents), replacing sections of floor, painting, rewiring, fixing leaks, and more.  Now it’s time to give up the sweet little cabin I’ve been renting, and move myself into the studio.  The day after tomorrow.

Half of it is still full of Dad’s potter’s wheels and other stuff that we haven’t had the heart to sell yet.  I think that is coming to a close, though, as Dad’s condition continues to deteriorate and as I told my mother yesterday, if a miracle occurs and he wakes up one morning cured of his dementia, I will buy him a brand new wheel to celebrate.

But what this post is really about is moving.  I’m sick of it.  I have moved so many times I can’t even count them.  Three times in the past year and a half, eight times in the four years before that, fourteen times in the ten years before that, and that’s where I lose count.

Going the opposite direction, nineteen times by the time I was sixteen, and then I ran away from home and until I got married at age 28 I was constantly on the move.  Even after I got married we moved a lot, being students, and after we divorced I kept going. 

I don’t know whether the instability of moving is a symptom or a causative factor of my illness. Maybe both.   I don’t know what it would feel like to be secure in my sense of place.  I suspect it would have a stabilizing effect on me.

I had a sample of that feeling of stability in Israel, where after a furious spate of moving (house sold out from under me two months after moving in, house flooded from roof leak, series of temporary room rentals while searching), I finally hit upon my dream house right in the middle of the most wonderful neighborhood in Jerusalem.  I had an infinitely renewable long term lease.  Three years into it, my father got so sick that I felt compelled to return to

America to be near him.  I kept the house in Jerusalem, sublet, in hopes that I would be able to return.

The sublet didn’t work out, and I had to give up the house.  It was then that I realized how the house had symbolized a solid stability that I had tasted, and had snatched away from me.

Now, in two weeks, I’m going back to Israel for two and a half months.  My Beloved and I are going to live together for that time.  Our aim, aside from enjoying being together, is to determine, if we can, whether we can make a life together as husband and wife.

I tell you, dearest readers, that if we can make it together, I only want to move one more time:  into OUR house.  Wish us luck.

Copyright 2012 Laura P. Schulman all rights reserved

Brain Worms

OK, I know the title is gross.  Horrifying, even.   How do you think I feel?  I have brain worms.

I don’t know, maybe you do too.  My friend Shmuel, who knows a lot of things, says he has them too.  In fact, he maintains that everybody has them.  I beg to differ, but I’d love to hear from you, dear readers, whether you do or do not have brain worms.

” Brain worm” is a term that refers to phrases of music that play themselves over and over and over and over and over, in your head.  The sounds are specifically from inside your head as opposed to true auditory hallucinations, which sound like they’re coming from outside your head, for example through the wall sockets or the sink faucet or just anywhere.

Brain worms can either be phrases of music that you know (the one that is playing in my head right now is part of an old-time fiddle tune, which has been rather pleasant but now it’s getting mucked up with some other not-so-nice cacauphonous mess), or in my case, often hard rock guitar riffs that I have never heard before.  I don’t even like hard rock.

The phrases are so clear that I can sing them.  They are often intrusive to the point that I lose my train of thought.

I asked my psychiatrist about them.  He didn’t know anything.  He told me I’m a doctor, go look it up.  That infuriated me, and if he hadn’t been so good to me over the years when I was really struggling I would have fired him on the spot.  But then, there are no psychiatrists in my area that are accepting new patients, so I’m stuck.  He called in some clonazepam, which has done squat.  To his credit, he did say that he thought it might be seizure related, and I do have cingulate gyrus seizures which cause me olfactory hallucinations if I don’t take my antiseizure medication.  Fortunately the smell hallucinations tend to be of something nice baking.  I shudder to think what they
could be, Heaven forfend.  So adding another seizure med does make sense.  It just hasn’t worked.

I Googled “brain worm” and found a “crazy forum” that had a lot to say about it.  Some found it related to OCD (Obsessive Compulsive Disorder).  I do score fairly high on the OCD tests, so maybe that’s it.   Other people said that increasing their doses of AAPDs (Atypical Antipsychotic Drugs) helped.  I do take Seroquel, and it helps with my PTSD symptoms, but it’s so sedating and mind-numbing that for now I’m just putting up with the intrusive tunes in my head.  Talk about I-tunes!  Aargh.

Thankfully the inner guitarist tends to shut up when I’m listening to “real” music.  I might have to turn into one of those nutters who walks around with stereo headphones on 24 hours a day.

Copyright 2012 Laura P. Schulman all rights reserved

The Depressed Self: Reblog from Depression Comix

**TRIGGER ALERT**
When I saw this new work from Clay it kind of hit me between the eyes. For most of my life, there was nobody you could call “Lost,” because I had never had the experience of NOT being depressed.

So of course I didn’t know that what I was had a name, “depression.” I did know that I felt like shit all the time, even (especially) as a child, and I didn’t want to be alive, and often really wanted to die. I even tried to one time, by riding my bike in front of a car. I got a head injury and a number of other wounds for my trouble, and was really angry at G@d that I didn’t get to die. I was 10.

I tried to kill myself again when I was 22, by breathing pure nitrous oxide. I did die that time, actually, but was in the presence of someone who knew CPR so I got sent back again. That story is for its own blog entry: this is just a teaser (sort of).

I never knew that what I was, was depressed, until I was in college. There was an ad in the student newspaper for paid volunteers for a drugs experiment in the psychology department. Free drugs plus money? Yeehah! I went and applied.

They gave me an entire day’s worth of psychological testing. I went home and waited for the call to come in and get my drugs, and my money.

I got a phone call, but not the one I wanted. You must go right away to Student Mental Health, they said. Your tests show that you are suffering from Major Depressive Disorder.

Hmmm. I wasn’t feeling any different than I always fely, but I dutifully trudged through the Chicago snow to the Student Mental Health Center.

After the usual wait, a nice lady called me into her office. I sat down. She smiled and waited. I had nothing to say, so she began,

“Well! I see that you were referred for Major Depressive Disorder.” She smiled bigger. “Well! You’re very attractive. I see you get good grades in school. So why are you depressed?”

I stood up, thanked the lady for her time, and walked away from there.

Depression Comix

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Wiped out

This week has wiped me out, mentally and physically.  I stay on a knife’s edge between functionality and nonfunction, largely with the aid of the Five Medications:  Lithium, Lamectil, Seroquel, Ambien, Ativan.

When I lived in Israel, 2007-2010, I was down to 50 mg. of Lamectil daily: practically a homeopathic dose.  I was on Lithium when I moved there, but the dry heat makes it very easy to get dehydrated, and that can be lethal on Lithium.  So my shrink had me very slowly and carefully wean off of it, since I had been very stable for several years by then.  I found that I felt no different at all without it, so I had nearly a four year vacation from Lithium.

I attribute my stability to the wonderful network of friends and advisors I had in Israel.  I have never felt so loved and cared for.  For the first time in my life I felt that I had family.  Lots of family.  Where else in the world can you walk down the street on the evening of a holiday or the Sabbath and have people you hardly know invite you to come and share their festive meals?

I had several extended visits back to the States during that period of time, for a few weeks or a month, keeping tabs on my aging parents.  I am the only child, and they are getting precariously old and poorly functioning.  Usually these visits were precipitated by some crisis or other:  my father had a stroke;  my father had surgery.  My father.

To say that my mother and I don’t get along would be a gross minimization.  The truth is, we are oil and water.  Actually we are more like gasoline and a match.  My mother knows how to devastate me with a look or a gesture.  Five seconds in her presence and I am once again a cowering child hiding under the covers hoping to become invisible to her rages.

I have lived my entire life trying to find ways to appease Mom, so that she would love me and not tear me apart with tooth and claw.  And wonder of wonders, none of it has worked more than briefly.

So each visit took its toll:  on one three week visit I became so depressed I had to go to Canada afterward for 30 rTMS (Repetitive Transcranial Magnetic Stimulation) treatments.  This is the best thing since sliced bread for treating major depression, PTSD, and a growing plethora of other neurological and neuropsychiatric disorders.  (I plan to write a future post about rTMS, so stay tuned.) Sliced bread or not, it’s really not what one wants to have to do in order to cope with a family visit.

In January, 2010, two months shy of my fourth anniversary of moving to Israel, I returned to the States on an open-ended visit, since my father’s health was declining rapidly and I wanted to spend as much time as possible with him before he became totally out of it.

I’m glad I did, as he is now at the stage of dementia where he is in another world most of the time.  He still recognizes people, but sleeps on and off all day, and can’t perform any tasks more complex than eating.  I am grateful that he’s still able to feed himself and do most of his activities of daily living.  I can see those decaying, too, though.  Soon he will be totally dependent on others.  It breaks my heart to watch it happening.

The price tag of my leaving my support system in Israel has been brutal.  In order to keep myself from going stark raving mad, I’ve had to work with my psychiatrist here to find a cocktail that will keep my bipolar stable while helping me to control the symptoms of PTSD that threaten to rage out of control every time my mother looks at me.

Sleep is a constant struggle.  Sleep is essential to the stabilization of bipolar disease.  In fact, one of my neuropsychiatrists treated hypomania or mixed episodes by inducing sleep for 24 hours.  It’s like hitting the reset button.  As we know, one of the huge bugaboos of PTSD is the eyes-wide-open-like-dinner-plates horrible sleep disorder.  So the combination of PTSD and BP is deadly.

Hence the addition of drugs:  more Lamectil.  Back on Lithium (hydrate, hydrate, hydrate).  Ambien for sleep, except that’s not enough to quell the PTSD horrors, so Seroquel to deliver the knockout punch.  Oh, and a benzo to keep the Mom jitters down to a dull roar.

Why do I do this to myself?

Copyright 2012 Laura P. Schulman all rights reserved