Grief intrigues me. I’ve been there and despite counselling, self-help books and prayer, I don’t understand it.
A few years after my divorce, my father died. Sixteen months after my father died, my mother died. Eight months later, my dog died. Several years passed and a long-term relationship ended. Then I crashed, slipped into a deep depression.
Compound grief – that’s what I call it. At some point, all that grief piled up and morphed into depression. There was a tipping point. Despite the time I’ve spent rubbernecking my own grief, I don’t know when or where I reached that tipping point but I sure as hell did.
Even with all the self-awareness and knowledge I have today, I doubt I would be able to identify that moment should I experience another loss and slide into – God forbid – a deep depression. So, how do doctors distinguish between grief and depression?
Apparently, it’s not easy. According to a study recently published in JAMA Psychiatry, there is grief, complicated grief and depression. This was the first randomized trial to explore the treatment of complicated grief in an elderly population and it emphasized the importance for doctors to distinguish the differences between grief, complicated grief and depression.
I normally don’t understand articles in JAMA. The articles look and sound like English but they are beyond my comprehension. Even the headlines baffle me. But I found this article on Medscape – essentially an email discussion about the JAMA article – that even I could understand.
We have a couple more studies that suggest that paralyzing key facial muscles with Botox can reduce the symptoms of depression.
In a recent 24-week randomized double-blind placebo-controlled study, done by Michelle Magid, MD, clinical associate professor of psychiatry at the University of Texas, 30 participants with depressive symptoms were randomized and give injections of Botox or a placebo between the eyebrows (which happens to be exactly where I need it.)
The men were injected with 39 units of botulinum and the women were injected with 29 units. At week 12, the placebo group crossed over to treatment, and the treatment group crossed over to placebo.Participants were evaluated at weeks 0, 3, 6, 12, 15, 18, and 24. The primary outcome was a reduction from baseline of at least 50% in the 21-item Hamilton Depression Rating Scale score.
In a yet-to-be-published study in the in the Journal of Psychiatric Research, Eric Finzi, a cosmetic dermatologist, and Norman Rosenthal, a professor of psychiatry at Georgetown Medical School, randomly assigned a group of 74 patients with major depression to receive either Botox or saline injections in the forehead muscles that enable us to frown.
I couldn’t hear what the man on 60 Minutes was saying because I was busy making dinner but I saw the scar across his face and figured he was a veteran or had been in a car crash.
I record 60 Minutes every week so I figured I would watch it later. I did and then I realized this was Virginia state Sen. Creigh Deeds. I vaguely remembered reading a few news stories about some senator’s son attacking his father and then killing himself but there was no follow up – just that the senator had pulled through.
I did not know that Deeds’ son, Gus, 24, had bipolar disorder and that he and his father had been in the emergency room trying to get treatment for Gus the day before the attack. Or that there were no beds available in the psych unit and so Gus went home – unlike other kids who can linger for days in emergency rooms waiting for a psych bed to open up.
The story got more horrific as it went along. Deeds gave us the unimaginable details of the attack and how he looked at his son as he sliced at him with a knife and told him how much he loved him. And then there were interviews with other parents who had been in similar situations, with children much younger than Gus – discharged from emergency rooms because there were no beds for psych patients.
All I could think while watching was… What The F-word is wrong with us! Sandy Hook wasn’t enough? Aurora wasn’t enough? Virginia Tech wasn’t enought? What astounds and infuriates me is that we – or at least I – know who is to blame.
An article published in today’s issue of the Journal of the American Medical Association has me kind of freaked out.
According to a press release advancing the article, Wide Variation Found in Quality of Evidence Used By FDA For Approval of New Drugs:
“Many patients and physicians assume that the safety and effectiveness of newly approved therapeutic agents is well understood; however, the strength of the clinical trial evidence supporting approval decisions by the U.S. FDA has not been evaluated.”
As someone who has been on not one, not two but a cocktail of three medications – two anti-depressants and a mood stabilizer – for more than seven years I am one of those persons who assumed that the safety and effectiveness of the drugs I take were established by the gold standard for evaluation: the randomized, double-blind study.
Apparently not. Dr. Joseph Ross and Nicholas Downing from the Yale University School of Medicine examined every FDA drug approval from 2005-2012. Their study included how many clinical trials were submitted to support the approval, how long the trials lasted, how many patients were studied and the outcomes used to define the drug’s effects and safety.
Being a recovered alcoholic and boozeless for nearly 14 years, you can imagine how wide my eyes opened when I read recent headlines about research on lomazenil.
The commotion began when some zealous journalists got loosey-goosey with the facts – claiming that researchers at Yale University had released results of a preliminary study showing that the drug lomazenil, when taken before drinking, weakens the effect of alcohol.
Well, turns out that is not exactly true. According to folks at Yale, there has been no study at Yale about lomazenil’s ability to thwart the effects of alcohol. Yale is NOT developing a “sober pill.”
Certain places intimidate the heck out of me, like the supplement aisle at any health food store. Whoa.
I just wish I had some Harvard expert telling me whether Omega-3s, St. John’s Word, SAM3 and folate would help my depression.
Voila! Next thing I know I’m at a fundraiser for psychiatric research at Harvard and Massachusetts General Hospital in this oceanfront mansion in Palm Beach, (also very intimidating) listening to Dr. Marlene P. Freeman, an associate professor at Harvard Medical School and expert in Complementary and Alternative Medicine.
Lord knows I wasn’t there as a philanthropist. I’m a journalist – I used my last buck to tip the valet. But every year Michelle and Howard Kessler, who own the intimating, oceanfront mansion, invite me to their fundraiser because they believe – regardless of how much money you have or do not have – “no family goes untouched.”
Since these are the heavy hitters in the world of philanthropy, Mass General brings in its best researchers – like Dr. Freeman. Among all of Dr. Freeman’s titles, positions and research, she chaired the American Psychiatric Association’s Task Force on Complementary and Alternative Medicine (CAM) – which focused on the potential benefits of Omega-3 fatty acids, St. John’s Wort, SAMe, folate, light therapy, acupuncture, exercise and mindfulness based psychotherapies in treating psychiatric disorders.
First of all, it’s pretty cool that the APA is taking CAM so seriously. Second, this whole event could not have happened at a better time because I am about to run out of my Omega-3 supplement and was wondering whether it was worth investing in some more.
And the answer is…yes.
Audrey Gruss has no problem talking about her mother’s depression — even to a large audience in a ballroom at an elegant hotel in Palm Beach, where everything and everyone looks so refined and polished. She speaks candidly – not as a victim but as a daughter. It is her way of taking at swipe at the stigma that still stifles families who need help.
“Hope is a very important word. It is also my mother’s name,” Audrey told a crowd at a fund-raising luncheon at The Breaker’s Hotel last Friday. Thirty five years ago Audrey’s’ mother had a “nervous breakdown.” She went away to a hospital. The doctors told the family very little about their mother’s condition.
“That was an era when cancer was thought to be contagious,” she said. “Patients weren’t told very much.”
Over the years her mother tried medications. “At certain time she was balanced but not totally.” Five years ago, Audrey’s mother died. About the same time Audrey became interested in the work of Dr. Jaak Panksepp, an Estonian born psychologist and neuroscientist who coined the term “affective neuroscience” – the study of the neural mechanisms of emotion.
To anyone who has depression, affective neuroscience is common sense. Of course emotions are related to activity in our brains. We might not be able to tell you how emotions affect our hypothalamus, cingulate cortex and hippocampi but we know there is something going on up there and it is not good.
I went back and read article in the Journal of the American Medical Association that started the debacle called “The Newsweek Article.” I am even more convinced that circulation trumped sound journalism in the Newsweek article.
Authors of the study published in JAMA base their findings on the results of six, randomized placebo-controlled trials of TWO ANTIDEPRESSANTS. Let me say that again: TWO ANTIDEPRESSANTS.
That phrase keeps rolling around in my head…
“Expensive Tic Tacs”
That’s what saved my life?
“Expensive Tic Tacs”
I just finished reading the controversial cover story – ANTIDEPRESSANTS DON’T WORK – in Newsweek‘s Feb. 10 edition. I don’t know where to start. How about
IS THERE AN EDITOR IN THE HOUSE????!!!!
I went to the Ryan Litch Sang Bipolar Foundation’s annual dinner dance in Palm Beach on Sunday night. I did not know a soul besides Joyce and Dusty Sang, Ryan’s parents, whom I met a couple of years ago when I wrote a story about the Sangs’ efforts to raise money for research into early onset bipolar disorder and to help find an empirical test for bipolar.
At age five, Ryan began exhibiting symptoms of Bipolar Disorder, a serious mental illness which manifests itself with recurring episodes of mania and depression. Unbeknownst to everyone, Ryan had decided to stop all prescription mood stabilization medications because he did not like their powerful side effects.
He believed he could control his illness, a decision all too common with Bipolar Disorder. When Ryan suddenly entered a manic episode, he had nothing to help stabilize his brain chemistry. He had not slept in days, and in order to sleep, he self-medicated. Tragically, Ryan passed away in his sleep. Ryan was 24-years-old.
It was a swank affair – black tie, champagne and lots of beautiful people with eye popping bling. Ruh-roh. My idea of jewelry is the permanent henna tattoo that wraps around my left wrist. I felt a teeny bit intimidated with my fake diamond earings, my one and only snazzy dress and my rental car. Thank God for Crest Whitestrips. At least I could stand there and smile if I nothing else.
But, no, as soon as I was introduced by my gracious host, I felt fine. “Christine has just written about book about her depression, bipolar and alcoholism…” Wow. That kind of intro usually provokes stammering and raised eyebrows. But not here. Everyone at this party had been touched by bipolar – whether a child, sibling, parent or other loved one. We all shared this one, very private secret about which we rarely speak. We all “get it” – as I like to say.
The walls fell down and, man, did we talk. It was so amazing to hear others tell their stories – what worked for them and what didn’t, …