Psychotic Experiences Are Not Always a Sign of Mental Illness

Hearing Voices UMB-O Dollarphotoclub_73109512According to a July 2015 article by Anna Medaris Miller for U.S. News and World Report, there are “lots of potential reasons someone might hear voices, including anxiety, stress, depression and a history of trauma.”

Of course, all of these are “good reasons to seek mental health help.” But don’t conclude that a mental illness diagnosis is the only outcome.

In the article, Miller quotes Lisa Forestell, the director of community support at Western Massachusetts Recovery Learning Community who has heard voices her entire life. “They’re playful and silly and they try to cheer me up when I’m sad.” She also quotes Dr. John McGrath, a professor of psychiatry at The University of Queensland in Australia and researcher at the Queensland Brain Institute whose research team found that 2.5% of the population has heard voices and 3.8% has seen something others didn’t see. Psychotic experiences, he says, “are more common than we had been taught. What we really have to do is go back and revise how these symptoms fit into the profile of mental illness.”

This isn’t to say that hallucinations are never a symptom of mental illness. The point really is that hallucinations are a symptom with a variety of possible causes, including mental illness, but possibly also stress or trauma. Dr. Joseph Pierre, co-chief of the Schizophrenia Treatment Unit at VA West Los Angeles Healthcare Center, and also discussed in the article, conducted a study that compared 118 people who hear voices at least once a month and have a psychotic diagnosis to 111 people who hear voices at least once a month but don’t have mental illness. He found differences, including the tendency for people with psychosis to hear voices more often, to hear them express negative emotions. The diagnosed psychotic subjects also had little control over their voices. In his study, Pierre compared hearing voices to coughs — “common experiences that are often, but not always, symptoms of pathology associated with a larger illness.”

To read the article see Living With the Voices in Your Head.

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New Drug “ITI-007” Shows Promise for Schizophrenia

????????????????????????????????????????????????????A new medication, now in phase 3 clinical development for the treatment of schizophrenia, is showing great promise, according to its manufacturer and developer, Intra-Cellular Therapies Inc., as presented at the end of March at the 15th International Congress on Schizophrenia Research (ICOSR) in Colorado Springs and this week at the 4th Biennial Schizophrenia International Research Society (SIRS) Conference in Florence, Italy.

“This drug has a different pharmacological profile than any of the other antipsychotics. We believe the unique serotonergic-dopaminergic-glutamatergic pharmacological profile represents a new approach to the treatment of schizophrenia in a single stand-alone therapy.”

According to Intra-Cellular Therapies:

“Our lead product candidate, ITI-007, possesses a mechanism of action targeting multiple brain systems and may allow a physician to fine tune the drug’s action in the brain by simple dose adjustments. At the lowest doses, ITI-007 has been demonstrated to act primarily as a potent 5-HT2A serotonin receptor antagonist. As the dose is increased, additional benefits are derived from the engagement of additional drug targets, including modest dopamine receptor modulation and modest inhibition of serotonin transporters. We believe that combined interactions at these receptors may provide additional benefits above and beyond selective 5-HT2A antagonism for treating agitation, aggression and sleep disturbances in diseases that include dementia, Alzheimer’s disease and autism spectrum disorders, while avoiding many of the side effects associated with more robust dopamine receptor antagonism. As the dose of ITI-007 is further increased, leading to moderate dopamine receptor modulation, inhibition of serotonin transporters, and indirect glutamate modulation, these actions complement the complete blockade of 5-HT2A serotonin receptors. In this dose range, we believe that ITI-007 will be useful in treating the symptoms associated with schizophrenia, bipolar disorder, major depressive disorder and other neuropsychiatric diseases.”

 

 

Next Meeting Addressing the Assessment and Prevention of Prodromal States

This month’s speakers are – Carla Means Ransom, M.A., LMFT, intensive services manager and Carissa Hsu, MFTI Clinical Therapist. They will present information about the Center for the Assessment and Prevention of Prodromal States (CAPPS), which is a family therapy based program that targets the transitional age youth ages 16 – 25 years. The program is funded by the Los Angeles County Department of Mental Health and located at Harbor UCLA. CAPPS works with the population who are showing prodromal symptoms, which are what an individual may experience prior to developing a mental illness.

The “prodromal syndrome” is not a diagnosis, but the technical term used by mental health professionals to describe a specific group of symptoms that may precede the onset of a mental illness. For example, a fever is “prodromal” to measles, which means that a fever may be a risk factor for developing this illness. However, not everyone who has a fever goes on to develop measles. In order to prevent measles from developing, you would try to get rid of your fever and take care of any other symptoms you might have. “At CAPPS, we focus on taking care of symptoms that may precede the onset of psychosis.”

Psychosis affects between 1% and 3% of the population, and typically emerges between the ages of 15 and 30. The prodromal phase of psychosis is the critical time period when individuals are showing signs that they are at risk for developing a psychotic illness.  This at risk phase may last anywhere from a couple of days to a couple of years. During this time, individuals often experience symptoms of psychosis at a subthreshold level of intensity or at full intensity for short periods of time. Individuals and their families may also notice changes in functioning, such as trouble with school or work and social withdrawal or anxiety.

Stanford study finds auditory hallucinations affected by local culture

FROM STANFORD REPORT, July 16, 2014, Hallucinatory ‘voices’ shaped by local culture, Stanford anthropologist says, by Clifton B. Parker. People suffering from schizophrenia may hear “voices” – auditory hallucinations – differently depending on their cultural context, according to new Stanford research.

Tanya Luhrmann, professor of anthropology, studies how culture affects the experiences of people who experience auditory hallucinations, specifically in India, Ghana and the United States.

In the United States, the voices are harsher, and in Africa and India, more benign, said Tanya Luhrmann, a Stanford professor of anthropologyand first author of the article in the British Journal of Psychiatry.

The experience of hearing voices is complex and varies from person to person, according to Luhrmann. The new research suggests that the voice-hearing experiences are influenced by one’s particular social and cultural environment – and this may have consequences for treatment.

The striking difference was that while many of the African and Indian subjects registered predominantly positive experiences with their voices, not one American did. Rather, the U.S. subjects were more likely to report experiences as violent and hateful – and evidence of a sick condition. The Americans experienced voices as bombardment and as symptoms of a brain disease caused by genes or trauma.

Why the difference? Luhrmann offered an explanation: Europeans and Americans tend to see themselves as individuals motivated by a sense of self identity, whereas outside the West, people imagine the mind and self interwoven with others and defined through relationships.

Luhrmann said the role of culture in understanding psychiatric illnesses in depth has been overlooked.

“The work by anthropologists who work on psychiatric illness teaches us that these illnesses shift in small but important ways in different social worlds. Psychiatric scientists tend not to look at cultural variation. Someone should, because it’s important, and it can teach us something about psychiatric illness,” said Luhrmann, an anthropologist trained in psychology. She is the Watkins University Professor at Stanford.

See the full Stanford News article HERE.

The Difference Between Bipolar Disorder and Schizophrenia

There are numerous mental illnesses that the medical field recognizes today, ranging from anxiety issues to depression and beyond. Two of the most serious problems are schizophrenia and bipolar disorder. They’re also two of the most confusing issues, largely due to the fact that they share a number of similar symptoms. Because of this, it’s often difficult for even professional psychiatrists to make an accurate diagnosis between the two. 

However, there are a few things that can help. First, it’s worth understanding the differences and similarities. For starters, schizophrenia is classified as a psychotic disorder that leads to delusions, hallucinations, and more. Bipolar disorder is a mood disorder, though it may manifest in ways that often seem similar to schizophrenia. 

The source of most confusion comes from the overlapping symptoms. For example, things like mania, depression, suicidal thoughts, social issues, and more are all common in both types of mental illness. The biggest difference lies in hallucinations. While those with bipolar disorder can experience hallucinations, they’re far more common among schizophrenics. And even when they do occur in those with a bipolar disorder, the patient will usually be far more alert and expressive when explaining those hallucinations. 

Many who begin to experience mental illness likely won’t even realize that they are suffering from the symptoms of one of these diseases – at the very least, they won’t be able to identify the specific issue they’re dealing with. Today, most psychiatrists will rely on counseling and on scans of brain activity in order to understand the exact problem. Since schizophrenic patients will show a loss of gray matter in their brain and those with bipolar disorder won’t show that loss, this is the primary method of distinguishing between the two when no other methods are working. 

No matter the problem, there are solutions. Modern medicine has led to numerous treatments that can help patients overcome bipolar disorder and schizophrenia. But the first step is simply figuring out which of the two one is suffering from. To find out more, contact us today.

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May is Mental Health Awareness Month

It is a time to remember that mental health is part of overall health. Mental health affects thought processes, relationships, productivity and the ability to adapt to changes in circumstances or cope with adversity.

So does mental illness.

One in four adults experience mental health problems in any given year. Those problems can contribute to onset of more serious long-term conditions. One in 17 adults lives with mental illness such as major depression, bipolar disorder or schizophrenia. Approximately one-half of chronic mental illness begins by the age of 14 and three-quarters by age 24.  Unfortunately, long delays−sometimes decades−often occur between the time symptoms first appear and when people get help.

Mental Health Awareness Month a time to learn to recognize early symptoms of mental illness and the importance of talking about concerns with a doctor or mental health professionals. Early identification and treatment can make a big difference for successful management of a condition.

For example, major depression is a mood disorder that is more serious than “feeling blue” or temporary sadness. Some people may experience it only once, but more than half have at least one additional episode over their lifetimes. Be alert to any combinations of the following symptoms:

  • Depressed mood (sadness)
  • Poor concentration
  • Insomnia
  • Fatigue
  • Disturbance of appetite
  • Feelings of guilt
  • Thoughts of suicide

Bipolar disorder involves cycles of both depression and mania.  It is different from the “ups and downs” that most people experience, involving dramatic shifts in mood, energy and ability to think clearly. Symptoms also are not the same in everyone; some people may experience intense “highs,” while others primarily experience depression. Mania involves combinations of the following symptoms:

  • Euphoria
  • Surges of energy
  • Reduced need for sleep
  • Grandiosity
  • Talkativeness
  • Extreme irritability
  • Agitation
  • Pleasure-seeking
  • Increased risk-taking behavior

Schizophrenia is a different type of mental illness, but can include features of mood disorders. It affects a person’s ability to think clearly, manage emotions, make decisions and relate to other people. Untreated, it also may include psychosis–a loss of contact with reality. Symptoms include:

  • Difficulty with memory
  • Difficulty in organizing thoughts
  • Lack of content in speech
  • Emotional flatness
  • Inability to start or follow through with activities
  • Inability to experience pleasure
  • Delusions
  • Hallucinations

Other types of mental illness include attention-deficit hyperactivity disorder (ADHD), anxiety disorders (including posttraumatic stress disorder), borderline and personality disorder. Mental Health Awareness Month is a time to learn about them. One resource is the National Alliance on Mental Illness (NAMI) which offers information through its website www.nami.org and HelpLine 1-800-950-NAMI (6264). With affiliates in hundreds of communities nationwide, NAMI also offers free education classes and support groups to individuals and families affected by mental illness.

Anyone who experiences symptoms of mental illness should see a doctor for a focused discussion about mental health concerns and assessment of potentially related physical conditions. The next step may be referral to mental health specialist. A range of treatment options exist. Education and connecting with others who have walked the same path or are facing similar issues also can play an important role

During Mental Health Awareness Month, please also talk about what you learn with family, friends and others. Help end the silence and stigma around mental illness that discourages people from getting help. This is a month to make a difference in our communities.

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Abnormal Retinal Blood Vessels with Schizophrenia

s_1451f1From Psychiatric News Alert: The blood vessels in the retina of the eye are abnormal in individuals with schizophrenia, according to the study “Microvascular Abnormality in Schizophrenia as Shown by Retinal Imaging” in the American Journal of Psychiatry. The senior researcher was Richie Poulton, Ph.D., codirector of the National Centre for Lifecourse Research at the University of Otago in Dunedin, New Zealand. The cohort included more than 1,000 individuals who were followed from birth to adulthood. At age 38, the subjects underwent retinal imaging. The researchers compared the retinal imaging results of 27 individuals who had developed schizophrenia with those of individuals who had not and found that the former had microvascular abnormalities reflective of insufficient brain oxygen supply.

s_1451f2These findings have both research and clinical implications, the researchers said. For example, “Longitudinal and high-risk studies can determine whether retinal vessel caliber in juveniles predicts risk of developing psychosis or accompanies the progression of schizophrenia….” And if that is indeed the case, then retinal imaging might eventually be used to track youth at high risk of developing psychosis, since it is noninvasive and available in many primary care, optometry, and ophthalmology centers, and could foster intervention earlier than is now the case.

For an in-depth review of the latest knowledge on the causes of and treatments for schizophrenia, see Essentials of Schizophrenia from American Psychiatric Publishing.