Review: Clinical Psychopharmacology made ridiculously simple

I am not the target audience for this book.

The book is written for primary physicians who find themselves in the position of prescribing psychiatric medications. That purpose can be seen in the distinctions drawn, throughout, between the sorts of psychiatric conditions that can be managed by a primary physician (such as prescribing antidepressants) and those for which referral to a psychiatrist is recommended (such as psychotic depression).

Still, though the book isn’t written for patients or family members as such, its clear, simple presentation makes it a useful reference for those patients and family members who want to get informed about their medications. We purchased a copy to bring to our support group meetings as a reference.

The book is divided into chapters that cover different conditions (e.g. bipolar disorder) or topics (e.g. enhancing medication adherence). There are tables showing the clinical mechanisms and dosages of different medications, decision charts for selecting the appropriate medication for a condition, and descriptions of how psychiatrists decide on their treatments, from when someone with depression may get referred for therapy alone and when medication is needed, to which medications are appropriate for which symptoms. Case studies discuss how a psychiatrist may adjust treatment depending on the response of the patient.

It’s a good book that can help take some of the mystery out of why your psychiatrist may be making the decisions he or she is making.

 

Unseen Contributor to Teen Mental Illness?

It has been bothering me for a few years now. The surge in young teens who seem absorbed in mental illness.

I first noticed it after I’d had my iphone for a while. Probably over a year after (I was 18 when I got it). I’d been diagnosed when i was 17, and was probably 19 when I noticed. I was on instagram when I got the random desire to see if there were posts about mental illness on there.

And what I saw horrified me.

Kids as young as 12 were posting horrible photos. Typically it was just the cliche depressed quotes over and over again. But there were also photos of other things… there was “thinspiration” where people would post skinny girls who were their “goal” look in terms of thinness. And then there was the pencil test to determine if you really are thin or not, so people posted pictures of those. And pictures of thigh gaps. But I can’t relate to eating disorders, never had one and don’t think I ever will. Then there were ones that flooded my search and were even triggering to me- self harm photos. They were everywhere. I was horrified.
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Review: Rethinking Positive Thinking

Rethinking Positive Thinking: Inside the New Science of Motivation by Gabriele Oettingen

I don’t know how many times I have listened to people in support groups declare that they have decided to apply positive thinking to their lives and then watched them crash and burn. People declare all kinds of objectives for their affirmations. They will lose weight. They will master their drug problem. They will control their anger. They will grow rich. Money will come to them without effort. They will find a millionaire and marry him. They will find a fabulous new job and leave all the cares of the old one behind them. Some goals are realistic. Others are simply fantastic.

Studies show that plain old positive thinking drags people into a depressive rut. Oettingen cites the example of her work examining the attitudes of East Germans versus West Germans. East Germans spend a lot of time thinking positively. They see themselves as rich, as coming into opportunities of a lifetime which change their life situation for the better. But they still end up at bars trying to drink their melancholy away, and they never get anywhere with these plans. West Germans set reasonable objectives, put in the work, and succeed. Even though their goals are less grandiose, they are happier than their former Communist counterparts.

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A Response to Marya Hornbacher’s Research Project

Kitt O’Malley put me onto a research project by Marya Hornbacher who is writing a book that “will profile the lives of people who have a mental illness or who work in the field, and she’s trying to develop a deeper understanding of how the public views mental illness.” I couldn’t resist throwing in my own two cents. Because I have a long track record of never being included in such studies, I thought I would share my answers to her questionnaire here for your consideration and discussion:

Has mental illness affected you personally? If so, how?

Yes, I live with bipolar disorder, PTSD, and ADD. I lived in quiet torment for many years, occasionally bubbling over in rages that left my wife emotionally overwhelmed. This left me with feelings of deep guilt, but I didn’t do anything at first because I had been told that suffering was part of life and I should just buck up and endure it. When I finally did seek help, I was diagnosed with major depression and put on Prozac. Because I was “cured” the next day, I sought no further insights into my diagnosis until I came to the brink of committing suicide at age 47.
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On Victor Frankl, and logotherapy

We who have come back, by the aid of many lucky chances or miracles – whatever one may choose to call them – we know: the best of us did not return.

I have just finished reading Man’s Search for Meaning by Victor E. Frankl. The book is written in two parts. The first part is an account of Victor Frankl’s experiences in several concentration camps, during WWII. The second is an account of Frankl’s system of therapy, called logotherapy, a humanistic variety of psychotherapy centered around the importance of finding meaning in your life. As Frankl says, in the first part, quoting Nietzsche,

He who has a why to live for can bear almost any how.

What ties the two parts together is the fact that, in relating his concentration camp experiences, Frankl focuses, beyond the bare fact of the abuses to which he and other Jews were subjected in the camps (those few who did somehow survive), on the psychology of being a concentration camp prisoner, both for worse (the decline, from constant hunger and weakness as much as anything, into numbness and apathy) and for better (where did prisoners find the resilience to keep going in the face of that horror). These sources of resilience include relishing brief moments of respite (a stolen potato or the chance to remove lice) or beauty (a sunset or a song), the memory of particular lines of literature and philosophy that speak to Frankl (Nietzsche, Lessing, Dostoevsky), hanging onto memories of the past (for Frankl, especially, the image of his wife, who would eventually prove to have died in another camp), humor, and seeking sources of meaning (for Frankl, an attempt to reconstruct, on scraps in shorthand, a manuscript that had been taken from him at Auschwitz, and a fantasy of a future Frankl, having survived, giving a lecture on the psychology of prisoners in concentration camps). That and a sheet of paper with the Shema Yisrael, received in the coat pocket of one who had already died, in place of the manuscript that had been taken from Frankl. When Frankl titles a postscript after his second part “The Case for a Tragic Optimism,” the fact that he has surely earned the “tragic” part of that case makes me trust the “optimism” part more.

Logotherapy, the school of psychotherapy that Frankl founded, and which he describes in the second part of his book, is a third school of Viennese psychotherapy, after Freud’s psychoanalysis and Adler’s individual therapy. In contrast to Freud’s will to pleasure, or Adler’s will to power, Frankl centers his psychotherapy on a will to meaning.
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A Bipolar Love Story (One-Sided)

Once upon a time, I knew a man named Genevieve Zuni (pseudonym). Now, a word on the name I picked for him before we begin.

I am deliberately giving Genevieve a woman’s name. This is not to humiliate him. I want to give him the something beautiful, and I don’t care if it’s a girl’s name.  But there’s also another reason for this, one that i’m not sure I can explain.  I have only experienced sexual attraction to girls.  I have only experienced romantic attraction, that I was sure was romantic, to girls.  Genevieve is like a girl to me because my feelings for him were just as strong as my past romantic and sexual feelings.  More on this later.

As for the last name, it involves a complex set of word associations that I do not wish to reveal.  I don’t want you to guess who he is.
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