Depression 101: Pop Quiz
Posted on | December 21, 2009 | No Comments
1. Which of the following is most commonly associated with SUICIDE?
A) Schizophrenia
B) Unipolar Depression
C) Bipolar Depression
D) Borderline Personality Disorder
2. Which of the following drugs is NOT used to treat depression?
A) Xanax
B) Prozac
C) Paxil
D) Cogentin
3. What percentage of patients diagnosed with Bipolar Disorder also have a co-morbid substance abuse problem?
A) 10%
B) 50%
C) 70%
D) 85%
4. Which of the following is NOT a commonly associated symptom of depression?
A) Anorexia
B) Anergia
C) Guilt
D) Hypersomnia
E) Asphyxiation
Key: 1)C; 2)D; 3)C; 4)ETiger Woods: Addiction or Antisocial Personality Disorder
Posted on | December 18, 2009 | No Comments
Addiction: The repeated and increased use of a substance, the deprivation of which gives rise to symptoms of distress and an irresistible urge to use the agent again and which leads also to physical and mental deterioration. The term is no longer included in the official nomenclature, having been replaced by the term dependence, but it is a useful term in common usage.
Source: Kaplan and Sadock’s Pocket Handbook of Clinical Psychiatry, 4th Edition
Antisocial Personality Disorder: ASPD is characterized by the inability to conform to the social norms that govern people’s behavior. It is usually but not strictly synonymous with criminality. Patients are impulsive, egocentric, irresponsible, impatient, and unable to tolerate frustration; reject authority or discipline; and lack of adequate conscience development.
Source: Kaplan and Sadock’s Pocket Handbook of Clinical Psychiatry, 4th Edition
Now that we have a couple of working definitions, let’s look closer at this current situation with Mr. Woods. Here is a synopsis of what is floating in the media, “Infidelity, as well as, unprotected sex with numerous women in America.” There have been interviews, cell-phone records and even an alleged baby that all belong to Tiger Woods. Will his fortune and destiny be impacted? Well this part remains to be seen, but he is currently having a serious battle with the monster called integrity.
After review of the data, interviews and of course CNN’s perspective, I am compelled to lend more towards the Addiction definition. It appears that there is an irresistible urge for a certain type of woman, with an undefined sexual encounters frequency. Currently, there are no documented frequencies of his sexual escapades, merely speculation. However, I am sure that we will know soon.
Now to the contraire, is my consideration of ASPD. This definition is less likely. Now Tiger has some elements of this disorder, i.e. “lack of adequate conscience development.” Tiger is in trouble. Now the public, media in particular, is ready to sacrifice this perfect and spotless lamb. My empathy and sympathy are both gone for this individual. Tiger Woods currently needs to process and work through some primary issues. I am available for a consultation sir!
Enough Said,
Ask Dr. O
Response to Previous Day’s Question
Posted on | December 21, 2009 | No Comments
Question: Does emotional pain ever go away?
Response: Only if the person is willing to forgive the person that hurt them.
Question of the Day: December 21st
Posted on | December 21, 2009 | 1 Comment
You are known for frequently being late. This issue comes up in a job interview. What should you do?
Does Your Child Have ADHD?
Posted on | December 11, 2009 | No Comments
Are you a believer in this disorder? Many people feel that as Psychiatrists, we are overmedicating children and are not utilizing non-pharmacological interventions enough. I use to have a problem with medicating children and thought that we where over medicating patients. However, after being up close and personal with some families, I have found this to be untrue.
There is a cohort of children who need both a stimulant and antipsychotic to control their behaviors. After doing a retrospective chart review, I discovered that 88% of my current child and adolescent patients need both types of medications. Their success rate, after being properly medicated, is phenomenal. The other interesting fact is that 90% of the patients are also diagnosed with CD (Conduct Disorder) or ODD (Oppositional Defiant Disorder). It appears that co-morbidity is the rule and not the exception.
Looking for the warning signs that your kid could have this disease?
- Failing grades
- Oppositional
- Disrespectful
- Fighting
- Acting-Out
- Irritability
- Fire-Setting
If your child consistently has 2 or more of the above signs and symptoms they should be evaluated as soon as possible by a licensed provider. Medication management may not be your first option, but it should certainly be considered in the treatment plan.
Enough Said,
Dr. O
Depression and the Economy
Posted on | December 9, 2009 | No Comments
We have had a terrible past 12 months, as it relates to the economy. Many people are wondering if the economy has had an impact on mental illness in America. Issues like foreclosure, bankruptcy, and unemployment has almost paralyzed this nation. When we talk about unemployment in America, we have now exceeded the 10% mark. This fact alone can send us Americans into the tail spin of depression, anxiety, and psychosis.
A prolonged plunging economy can lead to clinical issues. There are two prevailing arguments. One is that a bad economy lends itself to increased depression in certain groups. A poor economy can also have an impact on affected person’s physical health. In my private practice, the number of new patients was certainly up in the first two quarters of 2009. Although, the economy was almost devastating at this time, my financial growth was phenomenal.
Unemployment effects depression because it impacts self-esteem. When people can’t find work, they can’t support their families. This alone can be devastating to the bread-winner of any family. With the advent of single mother households, you can see how overwhelming our present economy can really be. Most men feel castrated and paralyzed when they can not provide for their families. This alone can lead to mood dyscrasias, or, in other words, depression.
Our next brief discussion should be about physical illnesses, like hypertension and diabetes. How is this economy affecting persons with these illnesses? Well, according to research, the economy is increasing blood pressures and deregulating blood sugars. Keep in mind that these two illnesses, over time, affect the vasculature of the cerebral hemispheres, and organicity can certainly lead to depression. In essence, this terrible economy can impact both the physical and mental body.
Points to Ponder
A Bad Economy:
- Impacts both physical and mental health
- Can lead to low self-esteem
- Can be dehumanizing to some men and women
- Can lead to increased suicides
Enough Said,
Dr. O
Do You Have Seasonal Affective Disorder?
Posted on | December 8, 2009 | No Comments
There has been a resurgence of depressed patients in my office the past couple of weeks. This is not an unusual phenomenon this time of year. There are various types of depression, such as major depression, dysthymia, Adjustment Disorder with depressed mood and SAD, and many people are unaware of this fact. First, I would have to ask many of my readers: what is your understanding of this chronic and sometimes deadly illness? I would probably get various sundry answers, but that is to be expected. Let’s talk for a minute about Seasonal Affective Disorder (SAD).
SAD is a form of depression that presents during the fall and winter months. Persons with this disorder may experience decreased energy, irritability, and somnolence (increased sleepiness). This disorder is more common in people who live further away from the equator. In essence, there is less sunlight and more cold and frigid temperature during the day. This disorder is more common in females than males. There is also an increased prevalence of patients with a co-morbid diagnosis of Bipolar II Disorder. Don’t forget that family history is also important with this disorder, as well as all other mental illnesses.
Is there a speculative hypothesis for the physiology of this disorder? Many of you know that herbalist have attempted to treat their patients with melatonin. The theory is that decreased melatonin is a possible etiology for depression. There is also the more accepted serotonin theory. Reduced sunlight during the winter and fall months can change serotonin levels in the body. In conclusion, there is a plausible scientific explanation for this variant of the disease, depression.
However, as with other variants of the disorder depression, SAD is treatable. Phototherapy is still a mainstay treatment for this disorder, but most of us also add a conventional antidepressant medication. Don’t forget psychotherapy, especially cognitive behavioral therapy, is also an essential part of any treatment plan.
Points to Ponder:
- This is a serious illness and a suicide risk assessment should be done on all persons presenting with the disorder.
- There is treatment for this disease that is evidenced based and has proven positive outcomes.
- This is a serious medical disorder and prompt attention by a licensed professional is always necessary.
- Phototherapy is a mainstay of treatment in geographic locations where sun is scarce.
Enough Said,
Dr. O
Avoiding Excessive Holiday Spending
Posted on | December 3, 2009 | No Comments
Being image conscious and trying to keep family members happy takes priority in many of our lives. Although this is a priority, it may not be financially easy for some of us during this post-recession period. In light of this year’s recession, we MUST take action against excessive holiday spending, new credit card debt loading and Christmas club loans that we will be unable to pay back during the first quarter of next year. This is an age old dilemma that a lot of us have not learned how to handle. Now that Black Friday and Cyber Monday are gone, let’s review the basics.
- Please pay your December bills first before any shopping.
- Next, budget your holiday spending based on what is reasonable in your bank account.
- Do not take out short-term loans during this period.
- Always set limits for holiday gifts, meals, etc. during this time of year.
- Don’t make promises, to loved ones, that will be difficult for you to financially keep, i.e. “I’ll get you that engagement ring”.
- One gift per loved one is definitely appropriate. Don’t try to buy love at Christmas time.
- Pull names if you are part of a larger family.
- Shop at Wal-Mart and other discount stores in your local area. You will be stimulating your own neighborhood economy and you will be pleasantly surprised at what nice gift ideas that some of the discount stores have available.
- Plan holiday meals that are financially reasonable.
- Don’t forget to put money into your emergency fund for 2010.
These are just a couple of ideas to help you during the most wonderful time of the year. As we forge new frontiers, we have to change some of our old ways. The excessive spending demon has taking charge of many lives during the holiday period. Interestingly, America has reduced in credit card debt over the last several months. Will many of us take the plunge back into oblivion? Will we continue in the cycle of insanity by running-up the credit cards again? And finally, will we enter into the New Year with excessive stress, searching for ways to enhance debt consolidation.
Points to Ponder:
- Most of the people that overspend during Christmas can not afford it.
- December is a good time to invest.
- 2010 financial goals should be jump started by dollars discovered in the 4th quarter.
- Time Waits for No One.
Enough Said,
Dr.O
Tiger Woods: What’s Love Got to Do with It?
Posted on | December 1, 2009 | 4 Comments
It is 2:25 a.m. Do you know where your golfer is? What is America’s renewed fascination with Black Men? Guess what, they have finally left Obama alone long enough to focus on another black man, Tiger Woods. I think that this last story is just ridiculous. We are at the tail end of a recession and in the midst of several wars, but all we can find to talk about is the possibility of Tiger Woods having an affair with a white woman. Is this another attempt at a modern day lynching?
“What do you mean, Dr. O, by another modern day lynching?” Well, let’s talk about Michael Vick for a brief minute. There are signs-up in Philadelphia that say “Hide your Beagle, Vicks and Eagle?” Do you remember in the early 80s when there were several missing and murdered African-American children in Atlanta? I do because at that time, I was in the age-group of those being killed. As a matter-of-fact, one of my classmates was killed. Do you realize that the Michael Vick conflicts got more media attention than any of the individual children that were killed? Do you realize that just the other day, a 5 year old African-American baby girl was sold by her mom, raped by her assailant, and then killed? This story got, at most, maybe 48 hours worth of national attention. However, the issue with Tiger Woods happened Friday night and is still in the headlines of CNN, and on the front page of USA Today. Talk about Tiger power.
What is the infatuation with the Black Male? Is it the fact that a large percentage of them are incarcerated in the criminal justice system, therefore there is a shortage of them free in America? Is it the color of the skin, their swagger, or their ability to solve mathematical equations? Is it there ability to be President and withstand all the foolishness of the media, or their unique ability to be arrested in their own house? There is a degree of inquisitiveness that currently surrounds the Black Man, so Tiger; your time is up. Mr. Woods stand strong and be just like the rock, Obama. This too shall pass.
Points to Ponder:
- Tiger does not have to give a statement to the police. This is the law in Florida.
- He had car insurance and if he does not want to repair this car, he has the money to purchase another one just like the one he wrecked.
- Is he the only professional athlete with a possible mistress? Of course not, get over it America.
- Will Nike, AT & T, Gatorade or EA Sports pull their endorsements? Folks probably not, this story just doesn’t hold water. (He is NOT a Holiness Pastor)
- Will the modern day lynching continue? Yes, only until they have another issue with Obama.
I know that you all thought I was about to lend myself to some hot, juicy, Tiger Woods gossip, but it just ain’t that major. Tiger Woods stand strong, remain quiet, and do your billionaire thing. I ain’t mad at ya!
Enough Said,
Dr. O
Holiday Blues (Depression)
Posted on | November 22, 2009 | No Comments
As we embark upon the holiday season, it is important to remember that this can be a difficult time for some family members and friends. Thanksgiving and Christmas are usually times of reflection and introspection. This is the time approaching the New Year, when we began to evaluate our wins and losses, celebrations and regrets, accomplishments and failures. As a lay person, you may not know when a point of criticality has occurred or is occurring; therefore you MUST seek out the proper licensed mental health professional to address depression. Suicide is the 11th leading cause of death in America, and should not be taken lightly.
The diagnostic criteria for Major Depression: (to be utilized only by licensed professionals)
Sleep Disturbances (too much or too little)
Interest, as in the lack of interest in activities are normally enjoyed (Also known as anhedonia).
Guilty Feelings (Hopelessness usually accompanies the guilt)
Energy, or lack of energy, known to professionals as Anergia
Concentration Difficulties (not related to ADD)
Appetite Disturbances (too much or too little)
Psychomotor Difficulty (retardation or agitation)
Suicidality*
*A medical emergency
Please be advised that if any relative or friends has more than 4 of the above signs and symptoms, you should strongly encourage them to seek medical attention.
You have to be aware of the soft signals for the “Holiday Blues”.
Soft Signs:
- Social isolation
- Irritability
- Short-tempered
- Carbohydrate craving
- Crying spells
- Decreased libido
A lot of people miss this medical problem. There may be several people, family and friends, that are predisposed to this illness, functioning around you daily. These groups, such as the chronically mentally ill and schizophrenics, for example are also predisposed to higher suicide completion rates.
Points to Ponder:
- All people with noticeable signs or depression should be evaluated by a licensed mental health professional.
- People with undiagnosed mental illness often complete suicide.
- There are effective treatment modalities for patients with depression.
- “Holiday Blues” and other forms of depression can exacerbate other medical problems, i.e., hypertension and diabetes.
- The overall rate is suicide completion in America is increasing.
If you need further help please feel free to call your local NAMI or Suicide Hotline: 1-800-273-TALK (8255)
Enough Said,
Dr. O