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September 2007 The Newsletter of the Mood Disorders Support Group/New York 2007, No. 3 $2.50 MOODS Serving people with depression and manic depression, their families and friends since 1981. In Search of Memory: Psychiatry, Psychoanalysis and The New Biology of Mind Eric R. Kandel, M.D. Nobel PrizePrize----winningwinning neuroscientist and groundbreaking researcheresearcherr October 1, 2007 Ask any doctor if mental illnesses like and moods had real physical compo- depression have biological roots and the nents. Eric Kandel’s work in locating the answer will invariably be yes. But fifty specific area in the brain responsible for years ago, so little was known about the memory changed the way that scientists workings of the brain that few realized think about the human mind, and his that our thoughts, mental processes years of neuroscience research have (continued, next page) Ask the Facilitators: Exciting New Therapies for TreatmentTreatment---- Practical Tips for Coping with Mood Disorders Resistant Depression Panel of MDSG Facilitators Sanjay Mathew, M.D. September 11, 2007 AwardAward----winningwinning researcher and expert on hardhard----totototo---- treat depression, Mount Sinai School of Medicine Good doctors and therapists are invaluable in man- November 6, 2007 aging mood disorders, but sometimes you also need advice on practical issues. Should you ever let your boss know about your illness? Does everyone have Dealing with depression is never this much trouble with insurance? When should you easy, but when multiple medication mention your depression to potential romantic part- regimens fail to do the job, or side ners? Are there any tricks for fighting insomnia and effects are so debilitating that cer- other side effects? The trained facilitators who lead tain treatments are not options, it’s our weekly support groups are just the people to easy to lose hope. Don’t. Research- answer these sorts of questions. Come with ques- ers have been making exciting tions of your own or just listen in. breakthroughs for treating these tough cases—what’s known as treatment-resistant depression. “We actually prefer the term ‘difficult to treat’ in- Inside… stead of treatment resistant. We’re finding novel Ask the Doctor ways to successfully treat this type of depression all Borderline personality disorder and the time,”says Sanjay Mathew, MD, assistant pro- mood disorders: the link……………3 fessor at Mt. Sinai School of Medicine and our No- (continued, next page) Moods Page 2 (Kandel, continued from page 1) Mood Disorders Support Group shed even more light onto the way our brains New York work. Now, Dr. Kandel turns his attention to the MOODS biological components of depression and psy- Copyright © 2007 by the chotherapy, arguing that therapy, particularly Mood Disorders Support Group, Inc. psychoanalysis, has suffered from a lack of sci- All rights reserved. $2.50 per issue. entific rigor. “To what degree can psychotherapy, Inquire about bulk orders. psychoanalysis, and biology come together? MDSG is affiliated with the Depression and That should be the new focus in the discussion Bipolar Support Alliance. of depression,”says Dr. Kandel, who posits that advances in brain imaging technology will help P.O. Box 30377, New York, NY 10011 Phone: (212) 533-MDSG enable a long-needed objective look at therapy. Fax: (212) 675-0218 Dr. Kandel is an eloquent writer and speaker on E-mail: [email protected] the interplay between biology, thought, and Web: www.mdsg.org mood. His recent book, In Search of Memory , has earned rave reviews of both its scientific Sarah Schmidt and literary brilliance. Editor Don’t miss this exciting opportunity to hear a Betsy Naylor luminary in the field of neuroscience speak Chair about mood disorders. Ivan K. Goldberg, M.D. Medical Advisor Michael Horowitz (Mathew , continued from page 1) Webmaster vember lecturer. New drugs, new combinations, All information in this newsletter is alternative treatments, and new approaches in- intended for general knowledge only and is volving electroconvulsive therapy and other not a substitute for medical advice or brain stimulation techniques are all making it treatment for a specific medical condition. possible for more people to find relief, says Dr. Mathew. “Making yourself aware of all the latest advances is a good way to work toward a better outcome.” Letters to the editor and Don’t miss the chance to get the lowdown on other submissions are the these cutting-edge treatments. welcome and will be printed at the discretion of the newsletter editor. Do you have a question for an MDSG Send contributions to: Newsletter Contributions lecturer? Email it in advance. MDSG-NY Our lecturers have always fielded questions from the audi- P.O. Box 30377 ence, but starting now, attendees can e-mail questions in New York, NY 10011 advance. If you have a question for any of our fall lectur- Or e-mail ers, send it to [email protected]. Lecturers will [email protected] . answer as many questions as possible, pending time re- strictions. Moods Page 3 Ask the Doctor Ivan K. Goldberg, M.D., Psychopharmacologist What is bor- ing moods with irritable, vere depression and derline per- mixed states are especially periods when I am less sonality dis- likely to be diagnosed with depressed, but I am borderline personality dis- order and order. seldom depressiondepression---- how is it related to free. This pattern has mood disorders? Interestingly, many people been continuing for with borderline personality over five years. Is there Borderline personality dis- disorder appear to be peo- any point in my taking order is characterized by a ple with a mood disorder, antidepressants? lack of control over feel- frequently cyclothymia, who ings, especially anger, in- have been severely ne- Would therapy help? tense and frequent mood glected or abused in their When people with the pat- changes, impulsivity, rejec- early years. Whereas only tern of depression you de- tion sensitivity, a fluctuat- 33 percent of psychiatric scribe—which is called dou- ing sense of the self, feel- patients without borderline ble depression—are treated ings of boredom or empti- personality disorder report with adequate doses of an- ness, disturbed interper- abuse or neglect, 75 per- tidepressants for 12 sonal relationships, and cent of those with border- weeks, about one half have suicidal threats, attempts, line personality disorder a good response. If the ini- or self-mutilation. report abuse or neglect. A tial antidepressant does history of abuse is associ- not work, a second trial The mood of people with ated with unstable interper- with an antidepressant borderline personality dis- sonal relationships, feel- from another class of drugs order frequently shifts be- ings of emptiness, and has about a fifty percent tween depression, anger, abandonment fears. A his- chance of working. and anxiety. tory of neglect is associ- ated with suicidal behavior. Other research indicates Borderline personality dis- It has been estimated that that adding therapy to order is closely connected about two-thirds of people medication can improve to mood disorders in a diagnosed with borderline outcomes. In a study in number of ways. There is personality disorder show a which patients with double much overlap between the significant bipolarity. depression were seen for symptoms of each, and if six- and twelve-month fol- one looks at the families of It’s also worth noting that low-up assessments, those people with borderline per- many of the medications who were treated with the sonality disorder, one sees used to treat mood disor- combination of medication a lot of bipolar disorder as ders also reduce the symp- and cognitive-behavioral well. toms of borderline person- therapy did better ality disorder. Patients who have ultra- than patients re- rapid cycling bipolar disor- I seem to alternate be- ceiving only medications . der and frequently chang- tween periods of se- Moods Page 4 The Reader’s Corner with Betsy Naylor The Bipolar Handbook: RealReal----LifeLife ers. In fact, he is one of those psychopharms who Questions with UpUp----totototo----DateDate Answers never prescribe antidepressants for bipolar depres- by Wes Burgess, M.D., Ph.D. sion. In his view, antidepressants have been devel- Avery/Penguin, 256 pp. oped for unipolar depression and are not the right meds for bipolar people. Of course many doctors $15 paperback feel just as strongly that bipolar and unipolar ill- ness are points on a continuum, and lately it A good friend recommended that I read The Bipolar seems that half of unipolars end up diagnosed bi- Handbook because he, an MDSG regular and uni- polar. In my experience as an MDSG facilator, it polar, found that the book clarified some important seems that bipolar and unipolar members talking concepts he had never understood before. I have about their episodes of depression sound similar read this sort of book before, a survey of bipolar as far as activity levels and feelings. illness and the process of getting better. However this book explained some novel One could certainly argue about these points of view and it helped my well-read differences, and Burgess’s book will friend, so it sounded like it might be not be the last word on the subject. worth a look. The book’s strength is in the way it lays out depression and its subtypes in a Most survey books on bipolar illness like way that makes readers recognize these cover basics like symptoms and themselves and gain some knowledge medications and then narrow the focus about their particular depressions. to more specific topics like the biochem- istry of the bipolar brain, psychotherapy, "When someone has been bipolar for or healthy life habits. Being bipolar my- many years, the illness influences hab- self, I am always looking out for such its of thinking and behavior,"Dr.
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