[RUEZ]

Sounds like a very serious condition.

[Scape]

Aye, it is. Sadly it doesn't look like one on the surface. In the day to day you may never know your co-worker or your neighbor is suffering. As family it becomes damage control going from one crisis to the next and it is totally random.

[Stagger_Lee]

but it is treatable with medications. Effexor XR and Paxil seem to lead the pack in treating BPD right now, but there are literally dozens of effective medications available.

[Scape]

Although treatable the reason why this condition can go on for 10 years or more undiagnosed is that you can lead a horse to water but you can't make it drink. They must be convinced that they are sick and then allow themselves to be diagnosed as such. That's a major problem, as if you sign yourself in for treatment you can sign yourself out but if someone else signs you in then your can't leave till you treated. A sacrifice that some in this condition see as extreme and unwarranted. If they want to play sane they usually can and spoof the tests. The only time your guaranteed that something will be done is if they are seen to harm someone else such an assault charge and jail time or a suicide attempt (harm to oneself) then the system can finally get traction and create a case history. Getting to that point can be a minor miracle however.

[Stagger_Lee]

While that can happen in extreme cases, most BPD sufferers do quite well, on a monthly or bi-monthly voluntary visit to their Psychiatrist, if they take their meds. But, stubbornness isn't reserved for Bi Polar Disorder, I forget to take my high blood pressure pills all the time, and I know better... lol (Shhh... and sometimes I skip a dose if I have something planned, like the other day I went to the Allstate 400 at the Brickyard, and if you know one major side effect of hydrochlorothizide... well.... lol)

[ziggy]

You might want to explain the difference between slow and fast cyclers.

Why can it go mostly undetected untill something traumatic happens to trigger it?
Is there another way to stimulate dopamine and other feel good chemicals in the brain without meds?

[Scape]

The trigger for bi-polar disorder is a chemical imbalance so your at the mercy of whatever effects that balance. Traumatic experience may or may not have anything to do with it and no the stimulation required to cure is long term in nature and there is no natural alternative currently readily and legally available.

[Stagger_Lee]

you can buy Dopamine, Melatonin and St John's Wart as natural treatments for milder cases of BPD over the counter in health supplements, but they are not FDA or Canadian government approved, just classified in the same class as vitamins. No long term study has really shown much of a benefit, but homeopathic practitioners swear by them. Melatonin as as supplement is not (or wasn't when I left Canada) approved for sale even as a supplement.

[RUEZ]

foxybcgurl foxybcgurl:

$1:

I've known clients so trapped by panic and anxiety, they hyadn't left their homes for months at a time..... it can be very crippling

I'm not that extreme, but it does keep me from alot of things that I really want to do....it explains why I haven't gone back to school like I want to so badly. Such a motivation killer.

I understand exactly what you're saying. I've experienced this.

[Stagger_Lee]

How'd you get through it, Ruez?

[RUEZ]

Stagger_Lee Stagger_Lee:

How'd you get through it, Ruez?

I haven't. I have learned to deal with certain situations. But it's a lifelong thing.

[Stagger_Lee]

You shouldn't have to feel like that, nor should you feel like that. Talk to your Dr., there may be more help out there than you realize. Yes, I know it sounds like I'm a big pill pusher here, but even a very low dose of Lorazepam can make a huge difference in the lives of those stricken with Panic/Anxiety Disorder.

[Stagger_Lee]

I thought this story would be of interest to this forum.







IndyStar.com Business

August 10, 2006


Zyprexa users await settlement payments
8,362 to receive checks related to side effects

More than 8,000 users of Eli Lilly and Co.'s top-selling drug should find out this month how much their pain and suffering is worth.




Getting check from Lilly: Fountaintown resident Deborah F. Wagers hopes to collect on a claim of $112,500 for diabetes brought on by use of Eli Lilly and Co.'s antipsychotic Zyprexa. Notices for payment from a $700 million Lilly settlement fund for 8,362 people in a claims pool could go out this week. - Danese Kenon / The Star

Notices of injury payouts to Zyprexa users, in Lilly's largest-ever liability settlement, will be mailed as early as this week to those who hoped to enjoy the pharmaceutical benefits of the antipsychotic drug but ended up with diabetic side effects.
The long-awaited award notices will be followed within weeks or months by checks from a $700 million fund Lilly has set up to settle claims from 8,362 people. Many are vulnerable patients with schizophrenia and manic depression, the two main conditions Zyprexa treats.
The payouts, ranging from a minimum fixed amount of $5,000 to well over $100,000 a person, amount to a windfall for patients, most of whom are poor enough to qualify for federal Medicaid assistance.
"The awards are significant," said Chris Seeger, a New York attorney who serves on a steering committee that represents plaintiffs. Payouts of more than $100,000 will be common, he said, with fewer than 1,000 people getting the $5,000 base award for those who suffered the least harm from the drug.
"People are anxious to get paid," said Seeger, who helped hammer out the agreement with Lilly in 2005. "They're very anxious to receive their compensation."
Deborah F. Wagers of Shelby County, who is part of the settlement, said she hopes to collect on a claim of $112,500. She said she was prescribed Zyprexa for depression from about 2001 to 2003, and she blames the drug for causing her to become diabetic. She said she injects herself with insulin five times a day now and has had difficulty finding a job. Unemployed, she previously worked as a gas station cashier.
"I think they should be paying it out," she said of Lilly's mass settlement. "I'm the one who has to suffer."
Wagers said she hopes to use her check to pay more than $10,000 in medical bills.
The settlement by the Indianapolis drug maker was part of an effort to head off a mass class- action lawsuit against it by trial lawyers around the country who signed on thousands of clients alleging they gained weight from Zyprexa or acquired blood-sugar problems. Many of the lawsuits were consolidated in one federal court in New York, where Judge Jack B. Weinstein has overseen the settlement.
At times, the elderly judge has chastised plaintiffs' attorneys for being slow in getting payments to their clients who are in the settlement. In June, Weinstein called the delay in processing claims "intolerable" and demanded the work be speeded up, saying, "I want to terminate this case. I have my 86th birthday Aug. 10."
The lawyers did pick up their pace, reaching the agreed-upon threshold of processing 90 percent of the filed claims by late July, said Seeger. Lilly could have rejected the settlement if the attorneys didn't get enough of their clients to take the money and drop their legal cases.
With more than 8,000 claims now processed, "the deal is a final deal. No backing out by either side," Seeger said last week.
The only imminent holdup to paying out the money: A few state governments, including Ohio, want a share of the settlement money to reimburse them for Medicaid payments the states made for patients, to cover diabetes-related expenses linked to their use of Zyprexa.
"A number of states are giving us a hard time over . . . lien amounts," Seeger said. "We'll be forced to hold back (payments) in states where we can't reach agreement."
Indiana hasn't objected to payments to its residents, so checks likely won't be held up to Indiana residents, he said.
Tom Beaury, an informational technology worker from Lake Luzerne, N.Y., said he is awaiting payment on a claim topping $200,000. He said he became disabled partly because of diabetes-related symptoms linked to using Zyprexa six years ago.
Beaury, 35, said he will use his check, in part, to pay off $30,000 in medical bills he has run up since his Zyprexa-related health problems began.
He is not bitter toward Lilly.
"I don't know how to comment on Zyprexa. Was it a mistake? Was it gross negligence? They had a mishap, and it affected me. But I think they've done a lot of people good."
Lilly spokesman Phil Belt said plaintiffs' attorneys are handling the payouts.
"We are pleased to hear that the process is moving forward," he said.
The settlement will produce a windfall for attorneys, too, although Judge Weinstein has capped legal fees at 35 percent for most claims paid. Still, that will amount to more than $200 million going to attorneys.
The settlement covered about 75 percent of the known Zyprexa claims against Lilly. But hundreds more have flooded into federal and state courts.
"The money attracts more cases," said Peter H. Woodin, a New York attorney appointed by the court as a special master to handle claims.
Lilly has set aside another $300 million to cover potential liability from the unsettled cases, which it has said it will fight in court.
The first trial from the unsettled claims could happen next year. Lilly employees are being deposed by trial lawyers, and the company has turned over more than 10 million pages of documents sought by plaintiffs' attorneys, Woodin said.


Call Star reporter Jeff Swiatek at (317) 444-6483.


Copyright 2006 IndyStar.com. All rights reserved

[Stagger_Lee]

What is Posttraumatic Stress Disorder?

Posttraumatic Stress Disorder, or PTSD, is a psychiatric disorder that can occur following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape. Most survivors of trauma return to normal given a little time. However, some people will have stress reactions that do not go away on their own, or may even get worse over time. These individuals may develope PTSD. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the person's daily life.

PTSD is marked by clear biological changes as well as psychological symptoms. PTSD is complicated by the fact that it frequently occurs in conjunction with related disorders such as depression, substance abuse, problems of memory and cognition, and other problems of physical and mental health. The disorder is also associated with impairment of the person's ability to function in social or family life, including occupational instability, marital problems and divorces, family discord, and difficulties in parenting.

Understanding PTSD
PTSD is not a new disorder. There are written accounts of similar symptoms that go back to ancient times, and there is clear documentation in the historical medical literature starting with the Civil War, when a PTSD-like disorder was known as "Da Costa's Syndrome." There are particularly good descriptions of posttraumatic stress symptoms in the medical literature on combat veterans of World War II and on Holocaust survivors.

Careful research and documentation of PTSD began in earnest after the Vietnam War. The National Vietnam Veterans Readjustment Study estimated in 1988 that the prevalence of PTSD in that group was 15.2% at that time and that 30% had experienced the disorder at some point since returning from Vietnam.

PTSD has subsequently been observed in all veteran populations that have been studied, including World War II, Korean conflict, and Persian Gulf populations, and in United Nations peacekeeping forces deployed to other war zones around the world. There are remarkably similar findings of PTSD in military veterans in other countries. For example, Australian Vietnam veterans experience many of the same symptoms that American Vietnam veterans experience.

PTSD is not only a problem for veterans, however. Although there are unique cultural- and gender-based aspects of the disorder, it occurs in men and women, adults and children, Western and non-Western cultural groups, and all socioeconomic strata. A national study of American civilians conducted in 1995 estimated that the lifetime prevalence of PTSD was 5% in men and 10% in women. A revision of this study done in 2005, reports that PTSD occurs in about 8% of all Americans.

How does PTSD develop?
Most people who are exposed to a traumatic, stressful event experience some of the symptoms of PTSD in the days and weeks following exposure. Available data suggest that about 8% of men and 20% of women go on to develop PTSD, and roughly 30% of these individuals develop a chronic form that persists throughout their lifetimes.

The course of chronic PTSD usually involves periods of symptom increase followed by remission or decrease, although some individuals may experience symptoms that are unremitting and severe. Some older veterans, who report a lifetime of only mild symptoms, experience significant increases in symptoms following retirement, severe medical illness in themselves or their spouses, or reminders of their military service (such as reunions or media broadcasts of the anniversaries of war events).

How is PTSD assessed?
In recent years, a great deal of research has been aimed at developing and testing reliable assessment tools. It is generally thought that the best way to diagnose PTSD-or any psychiatric disorder, for that matter-is to combine findings from structured interviews and questionnaires with physiological assessments. A multi-method approach especially helps address concerns that some patients might be either denying or exaggerating their symptoms.

How common is PTSD?
An estimated 7.8 percent of Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely as men (5%) to develop PTSD. About 3.6 percent of U.S. adults aged 18 to 54 (5.2 million people) have PTSD during the course of a given year. This represents a small portion of those who have experienced at least one traumatic event; 60.7% of men and 51.2% of women reported at least one traumatic event. The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect, and childhood physical abuse. The most traumatic events for women are rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse.

About 30 percent of the men and women who have spent time in war zones experience PTSD. An additional 20 to 25 percent have had partial PTSD at some point in their lives. More than half of all male Vietnam veterans and almost half of all female Vietnam veterans have experienced "clinically serious stress reaction symptoms." PTSD has also been detected among veterans of the Gulf War, with some estimates running as high as 8 percent.

Who is most likely to develop PTSD?
1. Those who experience greater stressor magnitude and intensity, unpredictability, uncontrollability, sexual (as opposed to nonsexual) victimization, real or perceived responsibility, and betrayal

2. Those with prior vulnerability factors such as genetics, early age of onset and longer-lasting childhood trauma, lack of functional social support, and concurrent stressful life events

3. Those who report greater perceived threat or danger, suffering, upset, terror, and horror or fear

4. Those with a social environment that produces shame, guilt, stigmatization, or self-hatred

What are the consequences associated with PTSD?
PTSD is associated with a number of distinctive neurobiological and physiological changes. PTSD may be associated with stable neurobiological alterations in both the central and autonomic nervous systems, such as altered brainwave activity, decreased volume of the hippocampus, and abnormal activation of the amygdala. Both the hippocampus and the amygdala are involved in the processing and integration of memory. The amygdala has also been found to be involved in coordinating the body's fear response.

Psychophysiological alterations associated with PTSD include hyper-arousal of the sympathetic nervous system, increased sensitivity of the startle reflex, and sleep abnormalities.

People with PTSD tend to have abnormal levels of key hormones involved in the body's response to stress. Thyroid function also seems to be enhanced in people with PTSD. Some studies have shown that cortisol levels in those with PTSD are lower than normal and epinephrine and norepinephrine levels are higher than normal. People with PTSD also continue to produce higher than normal levels of natural opiates after the trauma has passed. An important finding is that the neurohormonal changes seen in PTSD are distinct from, and actually opposite to, those seen in major depression. The distinctive profile associated with PTSD is also seen in individuals who have both PTSD and depression.

PTSD is associated with the increased likelihood of co-occurring psychiatric disorders. In a large-scale study, 88 percent of men and 79 percent of women with PTSD met criteria for another psychiatric disorder. The co-occurring disorders most prevalent for men with PTSD were alcohol abuse or dependence (51.9 percent), major depressive episodes (47.9 percent), conduct disorders (43.3 percent), and drug abuse and dependence (34.5 percent). The disorders most frequently comorbid with PTSD among women were major depressive disorders (48.5 percent), simple phobias (29 percent), social phobias (28.4 percent), and alcohol abuse/dependence (27.9 percent).

PTSD also significantly impacts psychosocial functioning, independent of comorbid conditions. For instance, Vietnam veterans with PTSD were found to have profound and pervasive problems in their daily lives. These included problems in family and other interpersonal relationships, problems with employment, and involvement with the criminal justice system.

Headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain, and discomfort in other parts of the body are common in people with PTSD. Often, medical doctors treat the symptoms without being aware that they stem from PTSD.

How is PTSD treated?
PTSD is treated by a variety of forms of psychotherapy (talk therapy) and drug therapy. There is no definitive treatment, but some treatments appear to be quite promising, especially cognitive-behavioral therapy, group therapy, and exposure therapy. Exposure therapy involves having the patient repeatedly relive the frightening experience under controlled conditions to help him or her work through the trauma. Studies have also shown that medications help ease associated symptoms of depression and anxiety and help with sleep. The most widely used drug treatments for PTSD are the selective serotonin reuptake inhibitors, such as Prozac and Zoloft. At present, cognitive-behavioral therapy appears to be somewhat more effective than drug therapy. However, it would be premature to conclude that drug therapy is less effective overall since drug trials for PTSD are at a very early stage. Drug therapy appears to be highly effective for some individuals and is helpful for many more. In addition, the recent findings on the biological changes associated with PTSD have spurred new research into drugs that target these biological changes, which may lead to much increased efficacy.

[Stagger_Lee]

Since there is such a debate on Pedophiles & the law lately, here's a paper I hope some will find an interesting read:

Fact Sheet: Pedophilia



Most adults who sexually molest children are considered to have pedophilia, a mental disorder described in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). An adult who engages in sexual activity with a child is performing a criminal and immoral act that never can be considered normal or socially acceptable behavior.


Pedophilia is categorized in the DSM-IV as one of several paraphiliac mental disorders. The essential features of a paraphilia (sexual deviation) are recurrent, intense, sexually arousing fantasies, sexual urges or behaviors that generally involve nonhuman subjects, the suffering or humiliation of oneself or one's partner, or children or other nonconsenting persons.


The Characteristics of Pedophilia


According to the DSM-IV definition, pedophilia involves sexual activity by an adult with a prepubescent child. Some individuals prefer females, usually 8- to 10-year-olds. Those attracted to males usually prefers slightly older children. Some prefer both sexes. While some are sexually attracted only to children, others also are sometimes attracted to adults.


Pedophiliac activity may involve undressing and looking at the child or more direct physical sex acts. All these activities are psychologically harmful to the child, and some may be physically harmful. In addition, individuals with pedophilia often go to great lengths to obtain photos, films or pornographic publications that focus on sex with children.


These individuals commonly explain their activities with excuses or rationalizations that the activities have "educational value" for the child, that the child feels "sexual pleasure" from the activities or that the child was "sexually provocative." However, child psychiatrists and other child development experts maintain that children are incapable of offering informed consent to sex with an adult. Furthermore, since pedophiliac acts harm the child, psychiatrists condemn publications or organizations that seek to promote or normalize sex between adults and children.


Diagnostic and Statistical Manual of Mental Disorders

The purpose of the DSM-IV (and of the manuals which preceded it) is to provide clear, objective descriptions of mental illnesses, based on scientific data. Psychiatrists and research scientists use these descriptions to diagnose an individual's mental illness, to communicate with each other in a common language about mental illnesses, to develop new treatments tailored to specific illnesses and to plan the most effective treatments for their patients. The DSM-IV is not a diagnostic "cookbook," but is intended to guide the psychiatrist's own informed clinical judgment. The DSM-IV and its predecessors are not legal documents. The cautionary statement in the introduction to the DSM-IV reads, in part: "The purpose of the DSM-IV is to provide clear descriptions of diagnostic categories in order to enable clinicians and investigators to diagnose, communicate about, study and treat people with various mental disorders. It is to be understood that inclusion here, for clinical and research purposes, of a diagnostic category such as Pathological Gambling or Pedophilia does not imply that the condition meets legal or other nonmedical criteria for what constitutes mental disease, mental disorder or mental disability. The clinical and scientific considerations involved in categorization of these conditions as mental disorders may not be wholly relevant to legal judgments, for example, that take into account such issues as individual responsibility, disability determination and competency."



Individuals with pedophilia may limit their activities to their own children, stepchildren or relatives, or they may victimize children outside their families. Some threaten the child to prevent the child from telling others. Some develop complicated techniques for gaining access to children. They may select a job, hobby or volunteer work that brings them into contact with children. Others may win the trust of a child's mother, marry a woman with an attractive child or trade children with other individuals. Except when pedophilia also is associated with sexual sadism, the individual may be kind and attentive to the child's needs in order to gain his or her affection, interest and loyalty, and also to prevent the child from reporting the sexual activity. Pedophilia usually begins in adolescence, although some individuals report they did not become aroused by children until middle age. Often the pedophiliac behavior increases or decreases according to the psychological and social stress level of the individual.


There is little information on the number of individuals in the general population with pedophilia because individuals with the disorder rarely seek help from a psychiatrist or other mental health professional. However, the large commercial market in pedophiliac pornography suggests that the number of individuals at large in the community with the disorder is likely to be higher than the limited medical data indicate. Individuals generally come to the attention of mental health professionals when their child victims tell others and when they are arrested. Pedophilia is almost always seen in males and is seldom diagnosed in females.


How Psychiatrists Diagnose Pedophilia


When evaluating who may have pedophilia, psychiatrists apply three criteria spelled out in the DSM-IV. (See "DSM-IV Criteria for Pedophilia," below.) All three must be present for the diagnosis to be made. Whether or not all three criteria are present, an individual who has had a sexual encounter with a child has committed a crime. Psychiatrists nationwide support the federal and state statutes that define the criminality of any sexual act or molestation involving a child.


Treatment for Pedophilia


Pedophilia generally is treated with cognitive-behavioral therapy. The therapy may be prescribed alone or in combination with medication. Some examples of medications that have been used include anti-androgens and selective serotonin reuptake inhibitors (commonly called SSRIs). But unlike the successful treatment outcomes for most other mental illnesses, the outlook for successful treatment and rehabilitation of individuals with pedophilia is guarded. Even after intensive treatment, the course of the disorder usually is chronic and lifelong in most patients, according to the DSM-IV, which is the reason that most treatment programs emphasize a relapse-prevention model. However, both the fantasies and the behaviors often lessen with advancing age in adults.


Additional Reading


Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), 1994, 886 pages, ISBN 0-89042-062-9, paperback, $42.95 (plus $5.00 shipping), Order #2062. Order From: American Psychiatric Press, Inc., 1400 K Street, N.W., Washington, D.C. 20005.


DSM-IV Criteria for Pedophilia

Over a period of at least six months, recurrent, intense, sexually arousing fantasies, sexual urges or behaviors involving sexual activity with a prepubescent child or children (generally age 13 or younger).


Has the person had repeated fantasies or urges about engaging in sexual activity with a child generally 13 years or younger, or has he actually had sexual encounters with a child? If a psychiatrist sees an individual who has engaged in sexual contact with a child, the diagnosis of pedophilia should be strongly considered. (An individual who committed a single act of molestation while under the influence of drugs, for example, but who had not intentionally targeted a child and was unaware of the victim's age, would not receive the diagnosis. However, this of course in no way diminishes the seriousness of the act of molestation.) A person need not have actual sexual contact with a child to be diagnosed with pedophilia. A person who is preoccupied with sexual urges and fantasies that disturb his functioning (that is, negatively affect his relations with others or impair his ability to work effectively) could also be diagnosed as having pedophilia, even without ever engaging in a sex act with a child.


The fantasies, sexual urges or behaviors cause clinically significant distress or impairment in social, occupational or other important areas of functioning.


Is the problem clinically significant? That is, has it caused "significant distress or impairment in social, occupational or other important areas of functioning?" (Note: The same criterion is applied throughout the DSM-IV to other mental illnesses.) Under this criterion, a sexual encounter with a child constitutes "clinical significance."


To make a DSM-IV diagnosis, the psychiatrist assesses the individual for either clinically significant distress or clinically significant impairment. Most individuals with psychiatric symptoms experience a subjective sense of distress that may include feelings such as pain, anguish, dysphoria (unpleasant mood), shame, embarrassment or guilt. However, there are numerous situations in which the individual has symptoms or exhibits behaviors that do not cause any subjective sense of distress, but nonetheless would be judged "clinically significant" and warrant a diagnosis of a mental disorder if they come to the attention of a psychiatrist. In such situations, this judgment is based on whether the presentation causes significant impairment in one or more areas of functioning, including social, relational, occupational and academic functioning. For example, it is well recognized that many individuals who are experiencing serious problems related to substance abuse (e.g., violent behavior, poor work or poor school performance due to alcohol or other drug use) deny that their substance abuse is causing them any distress. Such individuals would be given a diagnosis of substance dependence or substance abuse, in spite of their denial, if the psychiatrist determines that these substance-induced problems are causing significant impairment. Similarly, many individuals who act on their pedophiliac urges claim that their behavior is nonproblematic and may even claim it is "beneficial" to the child. Nonetheless, the DSM-IV would consider such individuals to have pedophilia because, by definition, acting on pedophiliac urges is considered to be an impairment in functioning.


The person is at least age 16 years and at least five years older than the child or children in Criterion A. Note: Do not include an individual in late adolescence involved in an ongoing sexual relationship with a 12- or 13- year-old.


Is the person at least 16 years old and at least five years older than the child who is the object of his fantasies or activities? Psychiatrists must use judgment when evaluating a person in late adolescence who is engaged in a single ongoing sexual relationship with a 12- or 13-year-old. Although such a person might not be considered as having pedophilia, such relationships often lead to other psychological, medical (e.g., sexually transmitted disease, pregnancy), social and family problems and should be strongly discouraged.






© Copyright 1997 American Psychiatric Association