The Good, The Bad, and The Ugly

I have been med-free for about a month now and thought I would list out the good, the bad, and the ugly:

The Good:

-My moods have been manageable. The first week after the wean I had a lot of depression, but I forced myself to do some exercise every time I felt myself seeping down lower, and each time the physical activity helped to boost my mood back into a safe range. Sometimes that "exercise" was just jogging in place for a few minutes, and sometimes I managed to dance to a few songs. Either way, it definitely helped!  Mania is a little harder to tame without meds, but so far my little manic spurts have been brief and reasonable. No major episodes of rage like I had on the Paxil.

-In addition to discarding psychiatric medication from my system, I have also cleaned up my diet. I have removed sodas and other sugary substances, and have greatly reduced the amount of unhealthy fats. I drink 1-2 cups unsweetened tea a day and the rest of the time I drink water. My meals now consist of less bread and more fresh fruits and vegetables.  I have done away with foods that have suspicious ingredients. While we can't afford to buy all organic food, I am trying to prepare meals with as little processing and chemicals as possible. I won't lie; the first week of eating this way I felt like crap. But since then, I have felt so much better, mentally and physically! This is more than trying to lose weight; this is a new lifestyle, and I really feel good about it.

The Bad:

-Major, major trouble sleeping!  Even though I wasn't on anything specifically for sleep, my meds must have played a part in easier slumber, because going to bed is such a struggle now!  It's usually 2-4 a.m. before I can finally get some rest.  My goal this week is to learn of some natural ways to induce a more restful sleep at night; feel free to comment with your own tried and true antidotes.

The Ugly:

-I haven't written in nearly a month. This part doesn't really have much to do with my reprieve from medication. I was having trouble focusing before, so it's more of a constant problem that I have yet to find a solution for. It also has more to do with time limitations than anything else. I am preparing a pre-K lesson plan for my son to begin his first year of homeschooling this fall, so between that, spending time with him now and my other obligations, there is not a lot of free time to write these days.  I have a lot of ideas, just no time for follow through. Maybe I will reach a more balanced existence soon :)

So, there ya have it. Overall, I am feeling wonderful. As I have said in previous posts, going med-free isn't for everybody! Talk to your doctor before making any changes to your own regimen.

The Glass

A psychologist walked around the room while teaching stress management to an audience. As she raised a glass of water, everyone expected they’d be asked the “half empty or half full” question. Instead, with a smile on her face, she inquired:

“How heavy is this glass of water?”

Answers called out ranged from 8 oz. to 20 oz.

She replied, “The absolute weight doesn’t matter. It depends on how long I hold it. If I hold it for a minute, it’s not a problem. If I hold it for an hour, I’ll have an ache in my arm. If I hold it for a day, my arm will feel numb and paralyzed. In each case, the weight of the glass doesn’t change, but the longer I hold it, the heavier it becomes.”

She continued, “The stresses and worries in life are like that glass of water. Think about them for a while and nothing happens. Think about them a bit longer and they begin to hurt. And if you think about them all day long, you will feel paralyzed – incapable of doing anything.”

It’s important to remember to let go of your stresses. As early in the evening as you can, put all your burdens down. Don’t carry them through the evening and into the night. Remember to put the glass down!

~Author Unknown

*Pub on YCN*Awakening the Endorphins

I recently let my exercise regime slide (again!) while battling a nasty case of bronchitis, but now that I can breathe normally I am easing ever so slowly back into a more active lifestyle. My own struggles with maintaining a fitness program due to bouts of depression, physical injuries, and lack of motivation are not uncommon. I could do the research and spout out statistics on how many people exercise on a regular basis and how many don't, but you know as well as I do those numbers don't really help you in bettering your own health. And chances are, you already know all the reasons why exercise is good for you. The hard part is actually doing it.

Those first steps toward the seemingly unattainable goal of good health seem only suited for mammoth godzilla strides, but it's much easier to go about it with baby steps. Start where you are. If you've been spending most of your time under the covers as many of us do during an extended depression, make your first effort to get out of the bed and walk over to the window for some sunshine for a few minutes. Tell yourself you can go back to bed afterwards if you want, but make yourself take that little trip to the window. If you have been on the couch watching TV, decide to do some stretches or march in place during the commercials. Even if it's just during one commercial. Keep taking those baby steps until you can go for a walk, a swim, or visit the gym - whatever suits you the best. For me right now, it's dancing along with my toddler to Dance 4. Let me be honest with you: I am no dancer! I barely get any of the moves in sync with what is happening on the screen, and I make sure the curtains are drawn to avoid traumatizing the neighbors. But I sure do make my son laugh while I'm trying, and that makes me want to exaggerate my moves to make him laugh even harder. My eleven year old daughter joins in the fun a lot of times too, while my thirteen year old tells us how stupid we all look! Whatever it takes to get those endorphins pumping, people. Whatever it takes.

And you can do it, I know you can! The problem a lot of times is we have it in our heads that we have to start right off with an actual "workout", like there's a special code of conduct we have to go about to consider it real exercise, but there's not! Do what makes you happy, energized and pumped for the rest of the day. Don't fixate your fitness efforts on what you will look like in the mirror, because those results will likely take weeks, months, maybe even longer depending on what your ideal body looks like. Instead, focus on how it makes you feel. Apart from some sore muscles, perhaps, you will most likely feel a spark of energy as your blood gets flowing due to movement, followed by a sense of confidence and wellbeing.  That's the endorphins talking, so listen in and keep doing what they like.  And don't forget to drink some water!

It is a cruel shame that many of the health issues that are improved by exercise (like depression, obesity, and fibromyalgia, for instance) are the very same ones that make it so hard to get up and get started in the first place! When you see no point in living, you see no point in taking care of yourself. When every joint in your body aches, you don't feel like moving any more than you have to. When regular daily activities cause you to be short of breath, it seems impossible and even scary to push yourself to do more. It's situations like this where you need to be upfront with your doctor. Express your concerns and ask for practical approaches to better health. Certain activities may cause you more harm than good, so please get a medical okay before doing anything strenuous!

Even small steps may be difficult at first, but it is worth it! Now, excuse me while I go exercise my two left feet...

My On Again-Off Again Relationship with Medication

Yesterday I asked at my Facebook page "What is the worst side effect you have ever had from a medication?" There were numerous responses, many of which I have also experienced from medications at one point or another. It's more than a little unfair that the drugs we are given to help us overcome an ailment of some sort can so often produce another ailment, sometimes much worse than the initial problem we were having!

My last post on this site admitted my recent self-wean off of one of my medications. I vowed to keep taking the drug, despite its inconvenient side effects, at least until I spoke with my doctor. But, since that post I have slowly weaned myself off all of my medications.

I'm not sure how I feel just yet. I have been a little weepier at times, and I *may or may not* be hallucinating (I am convinced the house I am living in is haunted, and I really don't think it's just a mental health issue).

I am also convinced the meds are only stifling me at this point. Rather than making day-to-day functioning easier, I feel like the drugs are creating more issues than they erase. It's a personal decision, and I am an adult, albeit a little unreasonable and delusional at times. I am certainly not suggesting anyone reading this follow in my footsteps and discontinue your medications. I am not endorsing that at all! I will repeat, this is a personal choice. Not a recommendation!

Having said that, I know my own personal history with mental illness. My bipolar symptoms tend to take a hiatus every now and then, and flair up at other times. The schedule seems to usually run as two years on, two years off. I have always been a strong believer in only taking medication when it is truly needed. Many might disagree with me, and they may very well have right to do so. But for me, I take the drugs to decrease debilitating symptoms, because at those times I really can't function without them. The side effects are a drawback, but they are better than the alternative...but then the tables flip and as my symptoms decrease so does my patience for those side effects.

But how do you know when you will be safe to wean off your medication when it may actually be the drugs' effectiveness giving you a false security of wellness?  It's a valid question, and that is why it's so important to speak with your doctor before making any drastic changes like this. Personally, I don't really know, but at the same time I do. I just get this feeling, the stifled feeling, and it prompts me to reevaluate my mental health status. This is not medically sound advice, because often when we "just know" that we are alright without treatment that is when we are the most unwell. It's easier to tell if a drug is working for, say, high blood pressure or a cold. You are certain of the symptoms present, and you are certain of what your recovery should feel like. With mental illness it's a lot trickier. Your mind is the ill piece, and this affects emotions and thought processing. It's hard to know exactly what the outcome should feel like. "Better", you say, and we all know what that means: a lack of the symptoms that produced this sense of misery in the first place. But would you trade a limp for an amputation? That's often what it can seem like, mentally speaking, when side effects rob you of even more of your abilities than the illness. It all comes down to input/output. How is what you are putting in your body affecting what is coming out? Of course, I don't mean bodily fluids, though the drugs can definitely make those a bit kooky at times too! But coming out as in meaning, how are you feeling? How do the people around you, the ones who know you the best, rate your behavior? How are you handling daily stressors? Do you feel like "yourself" or like the real you has been medicated away?

Most importantly, could something besides medication have the same or better success at controlling your most troublesome symptoms? Just like healthy lifestyle choices can help stabilize blood sugar in diabetes, it can make a huge difference in mental illness as well. Sometimes medication will still be needed to tame the worst of the illness, and sometimes it won't. But I think our biggest problem is that we seek an easy solution, a magic pill, that is going to make everything fine and dandy without much effort on our part. But medicine is more like a crutch than a new leg. It can be the support that helps you stay stable, but by itself pills are not a cure-all. I was going to type out a list of things that contribute to the wellness factor, but then a friend forwarded me 6 Steps Toward Resilience & Greater Happiness and it points out all the things (and a few more) that I would have mentioned, so that saved me some time :)  I highly recommend you read this useful material. And don't just read it; apply it to your life. Make an honest effort to get enough sleep, eat well, exercise, nurture relationships, seek out your purpose, and practice gratitude. See if it makes a difference. Then, if you begin questioning the need for medication, it's time to discuss things with your doctor and determine whether a med-free life is achievable for you. There is no shame in taking medication if you need it. Just because someone tells you how wonderful they feel without the meds, it doesn't mean that you will have the same results. But if you are struggling with side effects, even after your doctor has changed your medications several times, then it may be something to research.

I don't know how long I will go med-free this time around. It may be a couple of years, or I may have to resume them next week. Time will tell. It's been a rocky relationship, and I think it always will be. 

Mood Swings, I Miss You

A while back I wrote about my change in medications. I have been doing well on a new cocktail of Paxil, Tegretol, and Klonopin. While I was having some rage issues in the beginning, the increase in Tegretol seemed to fix that quite nicely, and I can't remember the last time I have felt more stable. Wonderful, right?

And then out of the blue I decided I should wean myself off the medication without my doctor's consent or consultation. I began last night by decreasing the Tegretol.

I admit it, not a wise choice.

The wild thing about it is, I know this is never a good idea. Not for me, not for anyone. The doctors will tell you that. The textbooks will tell you that. Common sense will tell you that. So why do so many of us do it anyway???

To be honest, I got bored.

The thing is, I have lived with rapid cycling bipolar disorder for so many years, and there has been so little medication could do for it. I had grown accustomed, albeit weary and miserable, to going through several ups and downs per day. I've been tried on several different medications, many that made the symptoms worse instead of better. I had a fairly good round with Cymbalta and Lamictal for a while, but alas they overstayed their welcome as far as my chemical imbalance is concerned and their magic decreased month by month until I could barely tell I was on medication at all anymore. It was time for a change. And Tegretol provided a new stability that I don't remember having in a really long time. At first I was happy and relieved about that, but then I got a little scared.

It feels as if I have lost a part of myself that I have known for a long time. It's a part of me that I have detested, especially during the lowest lows, and even during the highest highs, but without those I'm so...unchanging. When you've been mountains and valleys your whole life, it takes some gear adjustments to maneuver flat plains that go on for miles. I feared I would lose my creative side. My spontaneous side. My real side.

Just one day without the Tegretol has brought me back to the reality that I do not like those sides I left behind all that much. My mind has been racing, I've had intermittent depression throughout the day, and I've had a much harder time controlling my temper. I may have to accept the flatter side of me for a while. While the Paxil has done wonders for my social anxiety, the Tegretol has given me an outrageous appetite (think of Cookie Monster; that is how I look when I devour a meal now) and it has made me "dumb". I have trouble articulating my words. I forget simple words like "shelf" and "sweater". I can almost hear the wheels creaking in my brain as it tries to write this blog well enough for it to make sense. I apologize for that.

Up, down, backwards, diagonal: these are the moves we are used to. They are the things that make life so difficult, and yet it seems reasonable to feel a little grief when they wither away under the control of pills. That doesn't mean we should stop taking them. It doesn't mean we all are meant to take medication the rest of our lives either. But finding that proper balance is a slow journey, and we have to listen to our bodies' needs, not our minds' reluctance for change. Sadly, there's not one right answer that fits everyone's illness. Some people do great with just healthy eating, proper sleep, regular therapy, and exercise; some still need one or more medications in addition to a healthy lifestyle. And what works for a month, a year, or a decade made suddenly need adjusting with no warning. That is the "thrill" of brain disorders, and there's nothing boring about that.

Days of Our Bipolar Lives

 

If you've been tuning in recently, you may have noticed some posts with recipes. This is because I am going to be adding a new page up top shortly devoted to recipes and cooking tips. What does cooking have to do with bipolar disorder? you may ask. For me, dinner time is one of the most stressful parts of my day. From deciding what I have on hand to cook to making sure nothing burns to entertaining a rather rambunctious child during the whole process, I sometimes just want to give up and cry. Sometimes I do. Sometimes there are anger issues that result in multiple stabbings to a tuna can because the can opener wouldn't work. Just pretend I didn't tell you that last part, okay?  ;) 

The truth is, evenings are hard on any tired adult who has either worked outside of the home or wrestled with children all day.  If you are struggling with depression, anxiety, or other symptoms of illness, then that tacks on even more stress to the day. You may decide to order pizza, run to the nearest fast food drive-thru, or not eat at all, and none of those choices are very healthy. So I'm going to be sharing a few of my tried and true recipes that help me keep meal time as stress-free as possible. These recipes are easy enough for beginner cooks, frugal enough for life on a budget, and are at least healthier than a Big Mac and fries.

I am working on some non-food-related articles as well, but I ask for your patience as I am currently spending a lot of good quality time with my family. I do hope you will continue to read at www.bipolarly.com and if you have not done so already, please "like" me at https://www.facebook.com/Bipolarly. As always, take care of yourself and remember our motto:

“Do What You Can, With What You Have, Where You Are.”

 ~Theodore Roosevelt

Cheddar Bay Casserole

This recipe is super easy and super delicious! The biscuit topping is reminiscent of Red Lobster's famous Cheddar Bay Biscuits.
 

Ingredients:

 

2 cups chopped cooked chicken

 

1 cup chopped frozen broccoli, thawed

 

1 10 1/2oz. can cream of chicken soup

 

salt and pepper to taste

 

 

For Biscuit Topping:

 

2 cups Bisquick

2/3 cup milk

3/4 cup shredded cheddar cheese

1/4 cup butter, melted

1/2 teaspoon garlic powder

 

1/4 teaspoon Old Bay Seasoning

Preheat oven to 400 degrees

Directions:

1.)  Mix together chicken, broccoli, soup, salt and pepper, and spread into a well greased baking dish.

2.)  Mix together Bisquick, milk, and cheese. In a small dish mix melted butter, garlic powder and Old Bay seasoning. Add to Bisquick mixture and stir until well blended.

3.)  Spread topping over chicken mixture in the baking dish, making sure to coat evenly for better cooking results.

4.)  Place dish in oven and bake for 20-30 minutes, or until biscuit topping is thoroughly cooked.

Makes about 6 servings. Enjoy!

The Numbers Count: Mental Disorders in America

Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year.¹ When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.² Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness.¹ In addition, mental disorders are the leading cause of disability in the U.S. and Canada.³ Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.¹

In the U.S., mental disorders are diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).⁴

Mood Disorders

Mood disorders include major depressive disorder, dysthymic disorder, and bipolar disorder.

• Approximately 20.9 million American adults, or about 9.5 percent of the U.S. population age 18 and older in a given year, have a mood disorder.^1,2
• The median age of onset for mood disorders is 30 years.⁵
• Depressive disorders often co-occur with anxiety disorders and substance abuse.⁵

Major Depressive Disorder

• Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.³
• Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year.^1, 2
• While major depressive disorder can develop at any age, the median age at onset is 32.⁵
• Major depressive disorder is more prevalent in women than in men.⁶

Dysthymic Disorder

• Symptoms of dysthymic disorder (chronic, mild depression) must persist for at least two years in adults (one year in children) to meet criteria for the diagnosis. Dysthymic disorder affects approximately 1.5 percent of the U.S. population age 18 and older in a given year.^1, This figure translates to about 3.3 million American adults.²
• The median age of onset of dysthymic disorder is 31.¹

Bipolar Disorder

• Bipolar disorder affects approximately 5.7 million American adults, or about 2.6 percent of the U.S. population age 18 and older in a given year.^1, 2
• The median age of onset for bipolar disorders is 25 years.⁵

Suicide

• In 2006, 33,300 (approximately 11 per 100,000) people died by suicide in the U.S.⁷
• More than 90 percent of people who kill themselves have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder.⁸
• The highest suicide rates in the U.S. are found in white men over age 85.⁹
• Four times as many men as women die by suicide⁹; however, women attempt suicide two to three times as often as men.¹⁰

Schizophrenia

• Approximately 2.4 million American adults, or about 1.1 percent of the population age 18 and older in a given year,^11, 2 have schizophrenia.
• Schizophrenia affects men and women with equal frequency.¹²
• Schizophrenia often first appears in men in their late teens or early twenties. In contrast, women are generally affected in their twenties or early thirties.¹²

Anxiety Disorders

Anxiety disorders include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and phobias (social phobia, agoraphobia, and specific phobia).

• Approximately 40 million American adults ages 18 and older, or about 18.1 percent of people in this age group in a given year, have an anxiety disorder.^1,2
• Anxiety disorders frequently co-occur with depressive disorders or substance abuse.¹
• Most people with one anxiety disorder also have another anxiety disorder. Nearly three-quarters of those with an anxiety disorder will have their first episode by age 21.5 ⁵

Panic Disorder

• Approximately 6 million American adults ages 18 and older, or about 2.7 percent of people in this age group in a given year, have panic disorder.^1, 2
• Panic disorder typically develops in early adulthood (median age of onset is 24), but the age of onset extends throughout adulthood.⁵
• About one in three people with panic disorder develops agoraphobia, a condition in which the individual becomes afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack.¹²

Obsessive-Compulsive Disorder (OCD)

• Approximately 2.2 million American adults age 18 and older, or about 1.0 percent of people in this age group in a given year, have OCD.^1, 2
• The first symptoms of OCD often begin during childhood or adolescence, however, the median age of onset is 19.⁵

Post-Traumatic Stress Disorder (PTSD)

• Approximately 7.7 million American adults age 18 and older, or about 3.5 percent of people in this age group in a given year, have PTSD.^1, 2
• PTSD can develop at any age, including childhood, but research shows that the median age of onset is 23 years.⁵
• About 19 percent of Vietnam veterans experienced PTSD at some point after the war.¹³ The disorder also frequently occurs after violent personal assaults such as rape, mugging, or domestic violence; terrorism; natural or human-caused disasters; and accidents.

Generalized Anxiety Disorder (GAD)

• Approximately 6.8 million American adults, or about 3.1 percent of people age 18 and over, have GAD in a given year.^1, 2
• GAD can begin across the life cycle, though the median age of onset is 31 years old.⁵

Social Phobia

• Approximately 15 million American adults age 18 and over, or about 6.8 percent of people in this age group in a given year, have social phobia.¹
• Social phobia begins in childhood or adolescence, typically around 13 years of age.⁵

Agoraphobia

Agoraphobia involves intense fear and anxiety of any place or situation where escape might be difficult, leading to avoidance of situations such as being alone outside of the home; traveling in a car, bus, or airplane; or being in a crowded area.⁵

• Approximately 1.8 million American adults age 18 and over, or about 0.8 percent of people in this age group in a given year, have agoraphobia without a history of panic disorder.^1, 2
• The median age of onset of agoraphobia is 20 years of age.⁵

Specific Phobia

Specific phobia involves marked and persistent fear and avoidance of a specific object or situation.

• Approximately 19.2 million American adults age 18 and over, or about 8.7 percent of people in this age group in a given year, have some type of specific phobia.^1, 2
• Specific phobia typically begins in childhood; the median age of onset is seven years.⁵

Eating Disorders

The three main types of eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder.

• In their lifetime, an estimated 0.6 percent of the adult population in the U.S. will suffer from anorexia, 1.0 percent from bulimia, and 2.8 percent from a binge eating disorder. ¹⁴
• Women are much more likely than males to develop an eating disorder. They are three times as likely to experience anorexia (0.9 percent of women vs. 0.3 percent of men) and bulimia (1.5 percent of women vs. 0.5 percent of men) during their life. They are also 75 percent more likely to have a binge eating disorder (3.5 percent of women vs. 2.0 percent of men).¹⁴
• The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population.¹⁵

Attention Deficit Hyperactivity Disorder (ADHD)

• ADHD, one of the most common mental disorders in children and adolescents, also affects an estimated 4.1 percent of adults, ages 18-44, in a given year.¹
• ADHD usually becomes evident in preschool or early elementary years. The median age of onset of ADHD is seven years, although the disorder can persist into adolescence and occasionally into adulthood.⁵

Autism

Autism is part of a group of disorders called autism spectrum disorders (ASDs), also known as pervasive developmental disorders. ASDs range in severity, with autism being the most debilitating form while other disorders, such as Asperger syndrome, produce milder symptoms.

• Estimating the prevalence of autism is difficult and controversial due to differences in the ways that cases are identified and defined, differences in study methods, and changes in diagnostic criteria. A recent study by the Centers for Disease Control and Prevention (CDC) reported the prevalence of autism among 8 year-olds to be about 1 in 110.¹⁶
• Autism and other ASDs develop in childhood and generally are diagnosed by age three.¹⁷
• Autism is about four times more common in boys than girls. Girls with the disorder, however, tend to have more severe symptoms and greater cognitive impairment.^16,17

Personality Disorders

Personality disorders represent "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it."⁴ These patterns tend to be fixed and consistent across situations and are typically perceived to be appropriate by the individual even though they may markedly affect their day-to-day life in negative ways. Among American adults ages 18 and over, an estimated 9.1% have a diagnosable personality disorder.¹⁸ Several more common personality disorders include:

Antisocial Personality Disorder

Antisocial personality disorder is characterized by an individual's disregard for social rules and cultural norms, impulsive behavior, and indifference to the rights and feelings of others.

• Approximately 1.0 percent of people aged 18 or over have antisocial personality disorder.¹⁸

Avoidant Personality Disorder

Avoidant personality disorder is characterized by extreme social inhibition, sensitivity to negative evaluation, and feelings of inadequacy. Individuals with avoidant personality disorder frequently avoid social interaction for fear of being ridiculed, humiliated, or disliked.

• An estimated 5.2 percent of people age 18 or older have an avoidant personality disorder.¹⁸

Borderline Personality Disorder

Borderline Personality Disorder (BPD) is defined by the DSM-IV as "a pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts.”

• Approximately 1.6 percent of Americans age 18 or older have BPD.¹⁸

For More Information

Mental Health Information and Organizations from NLM's MedlinePlus (en Español).

References

1. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.

2. U.S. Census Bureau Population Estimates by Demographic Characteristics. Table 2: Annual Estimates of the Population by Selected Age Groups and Sex for the United States: April 1, 2000 to July 1, 2004 (NC-EST2004-02) Source: Population Division, U.S. Census Bureau Release Date: June 9, 2005. http://www.census.gov/popest/national/asrh/

3. The World Health Organization. The global burden of disease: 2004 update, Table A2: Burden of disease in DALYs by cause, sex and income group in WHO regions, estimates for 2004. Geneva, Switzerland: WHO, 2008. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_AnnexA.pdf.

4. American Psychiatric Association. Diagnostic and Statistical Manual on Mental Disorders, fourth edition (DSM-IV). Washington, DC: American Psychiatric Press, 1994.

5. Kessler RC, Berglund PA, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 2005 Jun;62(6):593-602.

6. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association, 2003; Jun 18;289(23):3095-105.

7. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) : www.cdc.gov/ncipc/wisqars accessed April 2010.

8. Conwell Y, Brent D. Suicide and aging I: patterns of psychiatric diagnosis. International Psychogeriatrics, 1995; 7(2): 149-64.

9. Kochanek KD, Murphy SL, Anderson RN, Scott C. Deaths: final data for 2002. National Vital Statistics Reports. 2004 Oct 12;53 (5):1-115.

10. Weissman MM, Bland RC, Canino GJ, et al. Prevalence of suicide ideation and suicide attempts in nine countries. Psychological Medicine, 1999; 29(1): 9-17.

11. Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK. The de facto mental and addictive disorders service system. Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry. 1993 Feb;50(2):85-94.

12. Robins LN, Regier DA, eds. Psychiatric disorders in America: the Epidemiologic Catchment Area Study. New York: The Free Press, 1991.

13. Dohrenwend BP, Turner JB, Turse NA, Adams BG, Koen KC, Marshall R. The psychological risk of Vietnam for U.S. veterans: A revist with new data and methods. Science. 2006; 313(5789):979-982.

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Georgia Sliders

It's been a dreary day here in Northeast Georgia, and I had a hankering for something reminiscent of island food. You know, something to take me away, something that tastes a little better than Calgon. With little on hand besides a package of frozen precooked shrimp and some hoagie buns, I was feeling a little shipwrecked before the boat took off. But then I came up with these Georgia Sliders, and I hope you enjoy them as much as I do!

Ingredients:

1-2 lb shrimp, cooked and chopped
1 large onion, finely chopped
2 celery stalks, finely chopped
1/2 green pepper, finely chopped
2 TB minced garlic
1/2 jalapeno, finely chopped
1 15oz. can black beans, mashed
2 TB butter or olive oil
2 eggs
1/2 cup wholewheat breadcrumbs
1/2 cup panko
1/2 cup lowfat mayo or fat free plain yogurt
salt, pepper, and Old Bay seasoning to taste
olive oil for frying
cheese of your choice, sliced to fit patty (I suggest Pepper Jack for that extra kick)
rolls or hoagie buns cut in half

Directions:

1.)  Combine cooked shrimp, onion, celery, peppers, and garlic in your favorite food processor and let it do the fine chopping for you.
2.)  Melt 2 TB of butter or olive oil in pan and saute shrimp, vegetables and garlic until vegetables are tender. While cooking, add salt, pepper, and Old Bay seasoning to your liking. Set aside to cool.
3.)  In a separate bowl, beat 2 eggs and mix with 1/2 cup of mayo/yogurt. Add the shrimp mixture, breadcrumbs, and mashed beans. Mixed together to form a firm yet workable consistency. By hand, roll into patties and bread with panko.
4.) Heat oil over medium heat and fry patties 2-3 minutes on each side or until golden brown. Drain on paper towels.
5.) lightly spread butter or oil on insides of bread and toast until lightly brown. Assemble with shrimp patty and cheese and place back in oven until heated through and cheese is melted.

Stack with your favorite garnishes: lettuce, tomato, pickles, tartar sauce, cocktail sauce, pico de gallo, coleslaw, fried onions, or whatever else floats your boat :)