Will someone please tell me that the last paragraph of an Associated Press article about a recommendation to screen all teens for depression is WRONG?

“Routine depression testing should occur only if psychotherapy is also readily available, the panel said.”

Does that mean that we should not bother testing teens who do not have access to psychotherapy? Does that mean we are going to just write off those teens who cannot afford or whose parents do not believe in psychotherapy?

I cannot believe that this is the recommendation of the U.S. Preventative Services Task Force, a government-appointed medical panel which sets guidelines for doctors. The panel’s new guidelines appear in the April issue of Pediatrics.

The article says an estimated 6 percent of U.S. teens are clinically depressed but it says nothing about the number of teens with dysthymia – a low-grade, long-lasting depression that I suffered in my teens and that would unexpectedly morph into a clinical depression. 

The article says that a “simple questionnaire can accurately diagnose depression in primary-care settings such as a pediatrician’s office.” However, there are a lot of kids out there who very rarely – or never – make it to a pediatrician’s office. These kids are vaccinated at school or at the public health department. These teens only see a doctor in an emergency room because they are uninsured and their parents wait until they are very ill before taking them for medical care.

About 10 percent of kids under 18 had no health insurance in 2007, the most recent data available. About 28 percent of young adults, 18-24 year-olds, are uninsured – making them the least likely of any age group to have health insurance. These are 2007 data. We can only imagine what the numbers are today as we edge toward double-digit unemployment.

Who is going to determine if “psychotherapy is readily available?” What is “readily available?” Just because there is a pediatric psychotherapist within a 5, 10 or 25 mile radius of the teen does not mean psychotherapy is “readily available.” Someone has to make sure the teen can read the questionnaire. Someone has to drive that teen to therapy (if the parents have a …

Say you are an alcoholic and/or addict and dual diagnosed (or triple diagnosed like me). You want to get clean and sober. You have heard that successful sobriety hinges on the one addict/alcoholic helping another. You seek help from a clean and sober addict/alcoholic – a mentor who will share his/her experience, strength and hope. A mentor who will guide you and make suggestions. Sounds like a good idea, right?

Well, it can kill you if your mentor tells you that you must stop taking anti-depressants, mood stabilizers or anti-psychotics because they are are “mood altering” drugs. Some recovering addicts/alcoholics refuse to mentor others who take these “mood altering” drugs. Some even say you are not clean and sober if you take these medications. 

This attitude is insane, ignorant, irresponsible, arrogant, dangerous, self-righteous and stigmatizes mental illness even more. Where do  people clean and sober for years – often with nothing more than a high school degree – get off thinking that they know more than a psychiatrist? Sure, there are ignorant psychiatrists who prescribe benzodiazepines, such as Xanax to a self-proclaimed addict/alcoholic. There are probably just as many addicts/alcoholics to do not tell their phsychiatrist that they are addicts/alcoholics so they can get a script for benzos. 

Studies have shown that 30-50 percent of addicts/alcoholics also suffer from a companion mental illness. I believe the number one cause of relapse among the dual-diagnosed is untreated depression and bipolar. ALL illnesses must be treated for us to become healthy and stay clean and sober. 

I slipped into a clinical depression seven years into my sobriety. I was one of those recovering alcoholics who thought that if I just worked harder and helped other alcoholics more I would feel better. It did not work. I finally surrendered after a friend in recovery told me that she had taken anti-depressants for years. I have taken anti-depressants and a mood stabilizer for years. I AM clean and sober.

These self-righteous recovering alcoholics and addicts need to wise up and shut up. In my opinion, it is okay – even helpful – to ask recovering alcoholics/addicts if they have been honest with their doctor …

One of the few good things about being in a deep, dark clinical depression is that it opens your mind. Wide open. Desperation and hopelessness will do that. It did for me. I found a God I could trust. 

I was raised an Irish-Catholic – no meat on Fridays, no chocolate during Lent and trading holy cards like baseball cards. Soon as I was old enough I fell away from the church. For decades I bounced back and forth – being an atheist, then an agnostic. It just seemed God never answered my fox hole prayers. Go figure.

When you are in enough pain, you will try anything. The medicine didn’t seem to be working. My therapy was at a standstill. Even exercise failed me. What the hell? Why not try God again? What seemed like more unanswered fox hole prayers turned into anger at God, pleading and bargaining with God. Without realizing it I was developing a relationship with a God I had never known. 

It finally came down to faith – faith that the medicine would work, faith that I would eventually come out of my black hole, faith that I could handle this, faith that something greater than myself could restore me to sanity. The choice was mine: take off my cape and surrender to faith or go back to wondering if my Prius could produce enough carbon monoxide to kill me. I surrendered to faith. 

My fox hole prayers were finally answered. I have a God in my life. She has a wicked sense of humor. He lets me rant at him. It shows itself in the corals and fish I see when I go diving to the bottom of the ocean. We have a pretty good time.

Nicholas Hughes, 47, hanged himself last week. Forty-six years ago Hughes’ mother, poet Sylvia Plath, placed her head in an oven and turned the gas on while her 2-year-old daughter and 13-month-old son, Nicholas, slept. Six years later Nicholas’ stepmother killed herself the same way.

Plath’s book, The Bell Jar, had a profound affect on me. I had never before identified with a fictional character and I became enamored with Plath. In a sick way, she was my hero. I was 16. In hindsight I should not have read that book when I did. I was too young and too sick. Her depression made her feel as though she was trapped under a bell jar, unable to breathe. Finally, someone felt just like me.

Suicide is not hereditary – at least geneticists have not proved it. However, studies have shown that  children whose mothers committed suicide are 7 times more likely to attempt suicide than children whose mothers do not. That statistic is why I am alive. I was suicidal during my last depression. I had tried to kill myself twice before.

My therapist and nurse-practitioner told me that statistic. They asked me to remember it when I had suicidal thoughts. It worked. I could never do that to my daughter. Regardless of how I feel about my own life, I love my daughter more than I imagined I could ever love another person. I would never put her life at risk – ever. Today she is 17. She is happy. She just found a dress for her school’s Junior-Senior Dinner. We are looking at colleges. She framed a picture of us and gave it to me for Christmas. 

She is my anchor to life. I am so blessed to be alive. I have a life I never dreamed of and I am finally the mother I always wanted to be. Don’t quit before the miracle.

I watched the movie Milk over the weekend. Sean Penn portrays Harvey Milk, the controversial San Francisco gay rights activist who became the first gay to hold an elected to office in the United States. 

While Milk is a history of the gay rights movement in the United States, it is also study of stigma and ignorance. Regardless of how you feel about homosexuality, there are stunning  parallels between society’s attitude toward gays and the mentally ill.

I did not know that gays were so persecuted. Exterminated in the holocaust, fired from out public schools and arrested for gathering in bars.  It reminded me of the Mental Health Bell, 300 pounds of melted down iron chains and shackles used to restrain the mentally ill in asylums.  It was commissioned and cast in the 1950′s by Mental Health America. I had a chance to ring the bell last year. As I laid my hand on the bell I thought about the wrists and ankles that the metal beneath my hand had touched. 

The asylums are gone but the stigma is not. In the movie Milk, Harvey Milk stands before a crowd and shouts “Secrecy is the enemy!” He does not ask other gays to come out of the closet. He demands it. He tells those on his staff to leave if they don’t come out to their parents, friends and employers.

Secrecy is our enemy, too. But I would never demand that someone to come out of the closet. These illnesses make us fragile. That kind of demand could make us sicker. Some of our illnesses are more stigmatized than others. Outing someone else or forcing someone to come out of the closet with their mental illness – whether it is alcoholism or schizophrenia – is wrong.

 I am at a point in my life and career that I can do so. It is one of the blessings of growing old. Would I have come out if my parents were still alive, I was still married and my career was new? I don’t know. For me, coming out was a …

I am in awe of Dr. Helen Mayberg. Actually, I am in awe of anyone who can drill holes in someone’s head, insert some wires and bring that person out of the most hopeless depression.

It is called Deep Brain Stimulation and, yes, the “stimulation” part involves electricity. But DO NOT think of this as the old-fashioned kind of shock therapy. It is far from that. Mayberg, a professor of psychiatry and neurology at Emory University, along with her colleagues found a small region, deep in the brain, called Area 25. This region of the brain sits inside the anterior cingulate cortex (I have no idea where that is but for I am mentioning it for those really smart readers). 

The neural circuits in this area are very, very busy in people with depression. This is the area heavily involved in cortisol production, sleep, and serotonin and emotion regulation in the brain. It’s the place where get our motivation and drive. DBS has worked wonders for people with Parkinson’s. Mayberg figured why not try it for people who have tried everything but nothing has given them relief – not even what is commonly referred to as “shock therapy.” As Mayberg describes is, electroconvulsive therapy re-boots the brain, DBS just tinkers with it.

The procedure is as freaky as the effect. You drill two holes in a person’s head WHILE THEY ARE AWAKE!. With the help of an MRI, Mayberg guides two wires into Area 25. She must find the exact position or the treatment will not work. A little battery pack, which lasts up to four years, is implanted under the skin near the patient’s chest.

During her first attempt at this procedure in 2002, she slowly turned up the current to four volts. Within seconds the patient said, “Did you do something? I feel a sudden sense of calmness.” Not all her patients responded this way, but many did. Can you imagine being in an operating room and a patient who has been told there is nothing more they can do, that their case is hopeless, suddenly says they feel better? 

The amazing thing about Mayberg, besides the procedure, …

Welcome to Rant-O-Rama, an occasional blog about stuff that really ticks me off in the mental health world. Please feel free to share your own rants. Believe me, it feels really good.

I was watching the nightly news on Saturday and, once again, I heard some talking head use the phrase “schizophrenic” to describe a situation as though it had multiple personalities. First, I do not like the colloquial use of a horrible disease as a metaphor. Second, I do not like the colloquial use of a horrible disease as a metaphor when it totally misrepresents the horrible disease!

Schizophrenia and dissociative identity disorder (aka multiple personality disorder) ARE NOT THE SAME! DID is a condition in which at least two distinct identities routinely take over a person’s behavior and interact with the environment in their own distinct way. (I wont’ even touch the debate as to whether DID should be a valid medical diagnosis.) When you think DID, think Sybil, Dr. Jekyl and Mr. Hyde, or the movies Fight Club or Bourne Identity or the series Captain Underpants.

Schizophrenia, on the other hand, IS a psychiatric diagnosis characterized by psychosis, in which sufferers ( and I do mean SUFFER) experience hallucinations or delusional beliefs. Although schizophrenia literally means “split mind” it is not DID. This is the illness that afflicted the Nobel Prize winning mathematician John Nash. 

This may sound petty. But to me it represents the ignorance that surrounds mental illness. I do not believe – nor do I want to believe – that people would do this deliberately. I do know that when I point this out to people who misuse “schizophrenic” that they don’t seem too upset about it. Maybe that is why it grinds me to much.

What do you think?

“Wow. That was a brilliant idea.”

That’s what I have been hearing lately in my head. Oh, I am so full of good ideas. They’re just popping out all over. I write them down. I share them and sometimes – with all my enthusiasm – I don’t share well. In fact, I probably scare people. But, boy, are they good ideas. They are such good ideas that I should – must – do something about them now. These brilliant ideas give me lots of energy. I work very hard on my ideas. I am very determined to make these ideas work. Wow, I feel really good!

My therapist says I am manic – getting way up there. “No, I am just going through a creative spell,” I tell her. “No, you’re not. This is your mania,” she says. And we go back and forth, with me leaving her office promising to call my nurse practitioner but not doing it.

This has been going on for about six weeks now. I haven’t worked this hard and much since my first newspaper job. Woo-hoo. I am kicking butt. So what if it’s mania. It feels goooood. I shared this with a good friend who was diagnosed with bipolar years ago. I am still a novice, diagnosed just two years ago.

She tells me that she knows her mania has kicked in when she tells herself, “Wow, that was a brilliant idea.” Holy cow! That’s the same thing I say to myself! This girlfriend has been my saviour during the last few years. I think of her as my mental illness mentor. She has been through everything I have but she has the tools and she knows how to use them.

“Yep. When I hear myself say, “That was a brilliant idea” I know I am manic,” she said. “I know when I go up that high, I am going to eventually come down and I have done that too many times.” 

We talk about the little weed in the backyard that just begged to be pulled that snowballed into trimming the hedges, pruning the bushes, fertilizing the yard and renting a chainsaw to get …

Uber philanthropist Audrey Gruss’ mother suffered from depression and she remembers what it was like growing up with a mentally ill mother. Gruss now lives part-time in a breathtaking oceanfront mansion in Palm Beach. Gruss has raised tens of milloins of dollars for other charities. Two years ago she decided to start her own. She created Hope for Depression with $25 million of her own money. The goal of the groups is to fund international international cutting edge research that seeks to integrate neuroscience with psychology.

When you see Audrey Gruss, a striking blonde always impeccably dressed and coiffed, you do not think football. Polo, yes. Football, no. Yet Gruss picked four-time Super Bowl champion Terry Bradshaw to speak at her second-annual fundraiser luncheon for Hope for Depression. Bradshaw was a very, very good choice. If you did not know that Bradshaw has depression, he will be more than happy to tell you about it. He is not bashful, even in a ballroom full of weathly impeccably dress and coiffed Palm Beach women. You gotta love a manly man who is willing to stand up in front of a bunch of women and confess that he gets choked up when he sees an elderly couple holding hands.

There he was, up on the dais, telling us how he hated every minute of every Super Bowl he won (FOUR!) and a dark cloud descended on him in the weeks after. The depression would paralyze him. He knew something was wrong. His three marriages failed. He dawged around for years, doing things he is not proud of. He hit bottom when he realized he would not be raising his two young daughters. He went to his preacher – “and cried my eyes out.” He went to a therapist and “cried my eyes out.” Then he went to a psychiatrist where he got an answer: “The diagnosis was a relieft. It explained why I had done so many things.”

So the quarterback who needed a cortisone shot in his elbow to relieve the pain before every game figured there must be a shot or a pill to fix his …

For four months every year – December through April – Palm Beach becomes ground zero for charity fundraising in the United States. Groups from all over the world descend on the island with hands open and pricey galas. We’re talking tiaras and couture gowns. Caviar and truffles. Private performances by members of Cirque du Soleil, Sheryl Crowe and James Taylor. Ticket prices: $500 plus. Venues: Donald Trump’s Mar-a-Lago and the historic Breakers Hotel.

Say what you want. It seems kind of weird when we are a frog’s hair from double-digit unemployment and Wall Street Armageddon. But if that’s what it takes to raise millions for mental health research – perennially at the bottom of the government-funded research food chain – so be it. 

During the last two weeks the big mental health groups came to town and brought with them a few celebs and the world’s top scientists. I get invited and I am honored to attend. It means so much to me to be out in public among people who do not doubt that depression is real. I love being able to talk about my illnesses without someone getting embarrassed or changing the subject.

I love listening to the scientists – even if I don’t understand what they are saying – and studying the brain scans they display on big screens. “Healthy brain on the right, depressed brain on the left.”  ”Healthy brain on the right, bipolar brain on the left.” “Healthy brain on the right, addict brain on the left.” I just want to shout – “See! It’s real! I’m not making this us! I am sick! Depression is real! Bi-polar is real! Alcoholism is real!” Except everyone in the ballroom knows that. It’s the folks outside that don’t know. 

I thought about writing just one blog about all these events. But there is too much – so much I want to say about each one, the speakers, the venues and the celebs. So, over the next few days I am going to share with you my experiences here in Palm Beach with the smartest, richest and most understanding people in mental health research and treatment. 

Have a great day …