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Seniors and Antidepressant Medications
Seniors are often reluctant to seek help for a mental health problem. Many elements can contribute to this reluctance. Seniors often feel they should not complain, should persevere or “be stronger” in order to overcome difficulties. These attitudes can serve folks well in some situations in life, but can result in a delay receiving help for a mental health problem.
If your loved one has taken the step of talking to his or her doctor about a mental health issue, that is a great accomplishment. If the diagnosis is depression, the doctor may recommend a course of action aimed at treating the illness to restore a sense of well being. Antidepressant medications are often recommended to treat depression. Many seniors misunderstand antidepressant medications and their role in the treatment of depression. In general, these drugs work on the brain to restore balance to the brain chemistry resulting in the alleviation of symptoms. These drugs are not “happy pills” or stimulants, a common misconception. They do not result in a feeling of being “high”. When effective, these drugs can restore a sense of wellness. Doctors have many drugs available to treat depression. Modern antidepressant medications are not addicting and have fewer side effects than older drugs.
Finding the exact drug, or combination of drugs, that provides relief can be a process. Patience is the key; it can take time to sense if drugs are working. Sometimes the doctor needs to try several different drugs to arrive at the correct “recipe” that will provide the benefit needed with minimal side effects. Seniors and their families should work closely with the doctor to find the right approach and make sure the doctor is aware of any side effects that have been observed.
Effective treatment of depression can enable folks to re-engage and enjoy the richness of life.
All Problems With Memory Are Not Alzheimer’s
Older folks who have problems with memory are at risk of being labeled with Alzheimer’s disease without a thorough understanding of all the dementias. Dementia is a general term referring to a slow, progressive decline in mental abilities that interfere with daily life. This can include forgetfulness, confusion and impaired memory. Sometimes there are changes in behavior and personality. There are many illnesses and conditions that can cause symptoms easily confused with Alzheimer’s disease. Heart disease, diabetes, liver and kidney diseases, brain tumors, severe brain injury, and substance abuse are a few possibilities among many. It’s very important to have symptoms of concern evaluated by a qualified medical professional with experience in diagnosing brain disorders. There may be approaches to help treat the underlying condition and/or treat the symptoms directly. Until there is a clear picture don’t assume a memory problem is Alzheimer’s disease.
There are resources available to help you. An excellent place to start is your local Alzheimer’s Association. You can request written educational material, attend educational presentations or speak to an information specialist.
Cancer Research Directions: It’s an Exciting World Out There
- New therapies are being developed that will provide more precise matching between patients and appropriate treatment.
- Scientists are looking for new “markers” circulating in the body that indicate the presence of cancer. This could help with earlier diagnosis. Generally, the earlier cancer is diagnosed and treated the better the outcome.
- New agents are being tested for some cancers that are less debilitating than previous drugs without sacrificing effectiveness.
- Novel ways to combine and administer multiple drugs to treat some types of cancer.
- Therapies aimed at stopping cancer cells from dividing without injuring normal cells.
- Drug research aimed at trying to “starve” cancer cells by cutting off the supply of nutrients cancer needs to grow.
- Identify how our immune systems can be used to recognize cancer cells that are present and target them for destruction.
- Development of new imaging approaches that allow doctors to see the cancer when it is very, very small.
Some of this research has been put into testing phases in animal or human studies and trials; some of the research is still in the exploration stage.
Researchers lead the way in looking to further our understanding of cancer, identify cancers at an early stage, provide effective treatment and allow patients
to continue with their lives. You can explore the cancer research horizons at The National Cancer Institute. This site also provides general information about cancer, cancer treatment,
and Clinical Trials.
Medication Errors
Medication errors can lead to confusion, medication misuse and potential harm. The Food and Drug Administration is making an effort to address this problem through educating health care providers, recording and monitoring medication errors for trends, and working with the drug industry to improve labeling. Health care providers are advised about commonly confused drugs (is it Zantac or Zyrtec?, Serzone or Seroquel? ), inconsistent abbreviations, and poor hand writing. While the FDA works with health care providers, consumers can play a significant role in reducing errors.
- How many bottles of medication are in your cabinet?
- How many doctors do you see?
- How many pharmacies do you use?
- Have you ever looked for an expiration date?
- Do you use vitamins or supplements?
Suggestions for consumers to help reduce errors and drug interactions include:
- At least YEARLY, gather your medications in a bag and bring the bag to your doctor on a visit. Do you still need all these drugs? Have many doctors prescribed medication? Does any ONE doctor know ALL your drug treatments? Review everything!
- If you take Over-the-Counter drugs make sure your doctor knows, some OTCs and supplements can interact with prescription medications.
- Carry a list with you: drug name, purpose, dosage, frequency.
- If you get a new prescription from your doctor, make sure you understand why and how it should be used. Ask questions.
- If a doctor writes a new prescription: request that the drug name and purpose be included on the label. Have you ever forgotten what that red pill was for??
- Consider using one pharmacy for all your prescriptions. Many pharmacies use a system that will produce an alert if there are potential interactions between drugs you are prescribed. Many folks use multiple pharmacies to save money; this can defeat the alert systems if the pharmacy does not know all your drugs.
- Is the print on your prescription bottle big enough to read? If not, ask your pharmacist if there is an option to help you. Some pharmacies dispense drugs with different color caps for different people in the family, this can help avoid “his and hers” mistakes when you take someone else’s medication by mistake.
- Pharmacists are great resources for drug information, get to know yours.
Do your part to protect your health, reduce errors and the serious health risks associated with medication errors.
Breaking Free: My Life with Dissociative Identity Disorder, by Herschel Walker and Dr. Jerry Mungadze
Book Review by Kathryn McCormack-Chen, LCSW
As a trauma psychotherapist, I read this book with great interest. When a well respected celebrity describes his experience with a medical or mental health condition it can present an opportunity for others to learn about the condition described. Public awareness can increase, stigma can be reduced and hope can be provided for others who share the same condition.
The diagnostic criteria for Dissociative Identity Disorder, as described in The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorder, 4th edition, are as follows:
- the presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
- at least two of these identities or personality states recurrently take control of the person’s behavior.
- inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
- the disturbance is not due to the direct physiological effects of a substance (e.g., blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (e.g., complex partial seizures).
I read and I read and I read some more, looking for the real diagnostic evidence that Mr. Walker’s described condition meets the above diagnostic criteria. I could only find one reference to any symptom that was perhaps related to any form of dissociative disorder. Mr. Walker stated that he would drive home from college on occasion and not remember the trip. In psychiatric terms this could be called dissociative amnesia, but the essential component that is missing, is that it did not cause him significant distress. Mr. Walker described the excessive bullying that he received as a child as well as being subjected to racist events in which mock hangings took place, both of which are certainly situations in which a child could be traumatized. He said that he grew up in a very close and loving family, but felt that his family’s way of handling things was to not talk about problems. So he did the best he could to manage by himself. I mention this about his family because in many cases family members will ignore or discourage a child’s expression of any kind of distress, but I suspect that his family would have comforted him. This is important because it is often the case with children who experience traumas that they do not feel support at home. So when Mr. Walker was able to go on in life and achieve great things, this overall environment of love and support contributed greatly to his ability to be successful. Put another way, we could say that the “good” in his life outweighed the “bad.”
Mr. Walker states that he believed he had “alters” (the name for these different personalities mentioned in the diagnostic criteria above). When he described the alters he had they never did take over his thoughts and behaviors to the point of severe distress. I believe that these “alters” were actually errors in thinking, the survival mechanisms used by trauma survivors often referred to as “codependent’” characteristics. In times of stress the person’s thinking patterns become more focused on outside influences than on one’s own internal judgment. The fact that Mr. Walker was always aware of these times when the proposed alters took over provides the ultimate contradiction for a diagnosis of dissociative identity disorder.
Finally, a word of caution to those who read a book about a famous person’s illness: do your research and check it out with knowledgeable professionals before you decide that you have the same disorder.
Kathryn McCormack-Chen, LCSW
What are the benefits that occur when a person stops smoking cigarettes?
I was recently reading the September 2008 edition of the AARP Bulletin and came across an article written by former Surgeon General Dr. C. Everett Koop. This article highlighted some meaningful statistics relating to smoking cessation.
Dr. Koop contends that it is “never too late to stop smoking” because the body begins to immediately heal some of the damage done by long-term tobacco use.
First of all, did you know that nicotine is more addictive than cocaine and heroin? Think about that if you have been trying to stop smoking without success. An old adage in addiction treatment that uninformed people often quote is “just say no to cigarettes.” Those of us who have worked in addiction treatment centers know that just saying no to any mood-altering chemical is not the answer. Nicotine addiction, like any other, has biological, psychological, and social components. Any kind of treatment aimed at smoking cessation needs to incorporate all of these components to enhance recovery rates. Another component of addiction treatment is what I call “deluge the clients with data.” This is important to help the person understand that any entity that meets the criteria for addiction has several components in common: addiction is a primary condition; it has a predictable course, and causes major harm to vital organs in the body. Sometimes just having more information helps the client to realize that nicotine does not calm her down; it just raises the level of nicotine in the blood so the craving for nicotine is temporarily lowered.
So today the data I want to deluge you with some positive statistics that Dr. Koop quoted about smoking cessation:
- After quitting your heart rate drops after 20 minutes.
- Carbon monoxide levels normalize after 12 hours.
- Heart attack risk drops, and lungs begin to reheal during the following 2 weeks to twelve months.
- Shortness of breath noticeably improves in one to nine months.
- Stroke risk equals non-smoker’s within five years.
There are several approaches available for people who are thinking about smoking cessation. There are over the counter products and/or prescription medications to curb nicotine cravings*, on-line support groups, hypnotism, and cognitive-behavioral therapy. But you must always consider the chances of medication interactions and the possibility of side effects that can occur when taking any new medications.…. Always check with your physician before trying any of these products.
(*Even using one of these products instead of cigarettes will eliminate your body’s exposure to tar, the reported cancer-causing agent in cigarettes).
A New Tool for Narcotic Dependence
The FDA has approved two new drugs which can be used to manage narcotic withdrawal. Narcotic drugs are also called opiates. There are many types of narcotic drugs, examples include heroin, morphine, Percoset, Vicodin, and oxycodone. The new drugs used in narcotic detoxification are called buprenorphine and buprenorphine/naloxone (brand names Subutex and Suboxone). These drugs can now be used by selected treatment programs and individual physicians to manage narcotic withdrawal. Traditional narcotic detoxification has used methadone, in a tapered dose, to help alleviate withdrawal symptoms over a short period of time until the addict is clean. Only specially licensed facilities could dispense methadone for this use. However, the stigma associated with narcotic addiction prevented some folks from availing themselves of programs offering narcotic detoxification and treatment.
The approval of these two new drugs was accompanied by new regulations that allow private physicians to treat withdrawal symptoms that accompany narcotic detoxification. Specially licensed private doctors can use these two new drugs in their office settings. The hope is the more comfortable and private setting of a doctor’s office will provide greater opportunities for addicts to get help. These new drugs are not for everyone, only your physician can determine if this is the right approach for you.
As with choosing any doctor, you should check the credentials, training, certifications and professional expertise before you decide on a particular physician.
Keep in mind that the introduction of these drugs does not replace the need for counseling services. Counseling approaches can assist addicts in repairing the damage to their lives caused by the narcotic addiction and prevent relapse. Physicians are required to provide information to their Suboxone patients about these supportive services and programs.
If you have decided to take the first step and want to contact a private doctor about narcotic detoxification, remember, the detoxification process is only the first step in getting well. The medication is not a short cut or a miracle end to dependence. Give yourself the best chance of recovering from narcotic addiction by using additional counseling services that are available to you.
We are familiar with many doctors in the area and we can help you select a qualified private physician to provide your narcotic detoxification services. If you are already in contact with a doctor, we can also assist you and your doctor in finding the best match of counseling services to meet your individual circumstances and needs. We have extensive knowledge of available treatment resources in the local area and we link with both nationally known and internationally known treatment programs. Your contact with us will be kept confidential