Diagnosis, DSM and Physician Affiliations

When you go to a psychiatrist or psychologist (or even your primary care physician), the first thing they pull out (whether in your sight or not) is a copy of the DSM (Diagnostic & Statistical Manual), the book that describes every mental disorder with all its symptoms and offers a means of making a diagnosis. It is the Bible of the medical profession and of every insurance company in the world, probably.

The question that needs to be asked, by people who'd like to really understand this book: How is this book constructed and who is involved in deciding what goes into it? Good question. It's a committee, the members can be found in the front of the book, that gets together and, based on their clinical experience and judgment, they make additions or deletions and decides what is to go into the book. There is also another medical "coding" book and that's the ICD-9 which is used for procedure codes and billing purposes. If you'd like information on this, go here. For the DSM, go to the publisher's website (American Psychiatric Publishing, Inc.) and also go to the National Institute of Mental Health for more information.

Are the physicians and psychologists who are on the committee to review and revise the book which describes mental disorders taking money from pharmaceutical firms? Perhaps that's not the right way to phrase that question. Do any of the committee members receive any funding from pharmaceutical firms? Probably most, if not all, do because the nature of research and funding is such that schools, hospitals and foundations cannot fund all work in this area. Funds are needed from pharmaceutical firms and the hope is that this does not cause bias in any form.

Might it cause some bias? Perhaps, but it's my opinion that professionals are not going to agree to revise a diagnosis or add a new criteria just because they have some funding from a firm that makes medications.

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• The Truth About Antidepressants
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Anxiety and Medication Compliance

No one wants to have a medical illness, especially one that requires that you have to either take pills or use an inhaler on a daily basis or inject yourself. For many, it reinforces the fact that you're "sick" or that you are not able to do what others can. For me, that's one side of the coin, but I think it's better for you, in terms of your compliance with treatment and your self-esteem, to look at the other side.

So, what's the other side of the coin? How about thinking that each pill or injection is proof that you have both the determination to maintain your health and that rather than reinforcing the fact that you're "sick," it means you're a winner. You won't let this stop you, or get you down because you're going to go on with your life and do the things you want.

Need examples? How about the actress Halle Berry who is a diabetic, but decided to be a successful actress and now a mother? How about Lance Armstrong who won the Tour de France multiple times while fighting testicular cancer? How about Bill Russell, the former basketball star, Bernie Mac, the comedian and Karen Duffy, the model, who all have sarcoidosis or Michael J. Fox who is fighting Parkinson's Disease and still is involved in entertainment? Gary Hall, Jr., winner of 10 Olympic gold medals has diabetes and so did Jackie Robinson.

Taking medication to help you control the symptoms of anxiety or depression or any other psychological disorder only makes you better for getting yourself into treatment. It may be anxiety provoking at first and even leave you with some concern, but what do you want to do with your life; live it or be controlled by the illness?

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• WebMD Video: Managing Your Anxiety
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Technorati Tags: anxiety, medication, diabetes, celebrity, wellness, healthy living

The Iraq War and PTSD: Finding Good from Bad

The number of casualties from this war is staggering. One piece of information that is particularly of concern is the number of both military and civilian personnel returning to the U.S. with symptoms of PTSD. One of the more difficult of the anxiety disorders to treat and one which has an enormous impact on families, PTSD has now become a focus of intensified research. Both therapy and pharmacologic interventions are being sought to more effectively deal with the trauma that gave birth to the disorder. Just as World War II helped psychologists and neurologists better understand physical brain trauma, this war is pushing the resources in research to look at psychological trauma. The initiative will serve all of us.

The National Center for Posttraumatic Stress Disorder, which is in the US Department of Veterans Affairs, now has both videos and FAQs related to this disorder and related issues. These issues concern the expectations of both the family and the PTSD sufferer. Questions center around actually talking about the topic, and the need to work toward establishing trust and closeness. Additionally, there are links to the resources you and your loved ones will need and how to gain access to them.

I've pasted a link to one site on my self-help page (a NAMI center) and the National Center also has a booklet (Returning from the War Zone: A Guide for Families) available only on-line here and a guide for military personnel is available here.

More specific information can be found at Veterans and their Families and addresses additional issues as well. They also have a video on a topic which has previously received less attention: women in the military. Well-known TV personality Jane Pauley narrates the video on military women.

If you have someone now serving in the military in Iraq or Afghanistan or who has come home, I urge you to visit these links. We all need to know what we can do to help with our veterans' return to a full life of physical and mental health.

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• WebMD Video: A Soldier's Road to Recovery
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Technorati Tags: Iraq, Afghanistan, veterans, PTSD, family, stress, anxiety

School Stress and Tragedies

School appears to many to be a time when everything is going right for students and all they need to do is study, get good grades and learn how to be good citizens. Unfortunately, the recent events with regard to campus shootings and other tragedies fly in the face of such beliefs.

The pressures of school are felt by all students, but for some the pressures are more than they feel they can handle. It's at these times, and even before, that efforts need to be made to reach out to these students to help them see that there are solutions for problems, pressures can be handled and help is there for the asking. It is, however, it is this "asking" that may prevent some students from getting the help they need.
How can schools, teachers and parents approach this dilemma and attempt to short-circuit tragedy? The first step must be to recognize where the pressure is coming from and then we can look at ways to help.

Stress in school comes from several areas: schoolwork, expectations of parents, the student's expectations of themselves, and personal relationships. There may also be times of the year when this stress is greater than others. For instance, just around mid-terms and finals time, holidays when students are heading home, or at graduation time. These are all prime stress times because of the added pressure to achieve, the loss of person contacts and support and the new challenges graduates face.

The time to help is when students just enter their school activities and I would urge that all students receive on-going workshops, stress refresher training, and that the counseling office make itself known on a daily basis. We can't always expect these students to come to us and we have to begin to go to them. It's really a mission to reach out to students and their parents because the two, working together, can be most effective in helping.

Things to Remember

Keep the following in mind:

1. There are no "failures" in life or coursework; everything is a learning experience
2. Being stressed is a part of life and there are things you can do
3. Give yourself some mental distance from the problem and talk it over with someone
4. Asking for help, no matter what the problem, is always a good, positive move
5. Nobody's perfect

Pin this list up on your desk or the refrigerator or paste it on the wall and look at it daily. It's one way to help you keep a healthy focus on things.

Are you feeling stressed in school? Know someone who is? Try a visit to our support group or discuss things with other members on our Health Cafe message board.

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• Stress, Relationships and Your Health
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Gunshots on Campus - Advice for Families

We send our children to school each day and our older children go away to college to begin learning more life skills to prepare them for their careers, their futures and to have an opportunity for independence. We always expect that they will return to us safely, but that doesn't always happen. When it doesn't, our faith in their safety at school is shaken, and now there's been another shooting in a lecture hall on the campus of Northern Illinois University.

This isn't the first time we've seen this and it's not the first time we've seen it at a university. Who can forget last year's shooting at Virginia Tech or the attack at the University of Texas at Austin when Charles Whitman climbed into the bell tower and held the entire campus prisoner?

What is the appropriate action for the school, the parents, the students and our country? No one has the magic formula, but one thing we do know is that going on with life, as before, won't be easy, but it's the only way to defeat the anxiety and stress being experienced. The trauma of the incident will not disappear, but how everyone responds will make all the difference.

Families are the primary support now and families must be included in any actions taken on behalf of the students. The strength they can provide for each other is not something that can be offered by schools alone.

Reassurance, not overreacting and maintaining calm is essential. The students may not experience any symptoms of stress immediately, but that doesn't mean that the storm is over. Counseling and learning how to use this situation in a positive way is also essential. I am a strong proponent of "good from bad" and I believe we will find some good here, too.

The main thing all of us want to know is what happened and what were the factors that set this deadly plan into place. Those answers are yet to come.

Still concerned or anxious? Come join our discussion on the Health Cafe.

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