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Personalized Blood Tests Provide Better Way to Predict Suicide Risk
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A newly developed universal blood test can help to predict if a person is at high suicide risk. Indiana University researchers say the test is unique as it can be given to everyone. The scientists also report the development of personalized blood tests for different subtypes of suicidality, and for different psychiatric high-risk groups.

Researchers explain that two apps — one based on a suicide risk checklist and the other on a scale for measuring feelings of anxiety and depression – have been designed to be used in conjunction with the blood tests to enhance the precision of tests and to suggest lifestyle, psychotherapeutic, and other interventions.

The scientist have also identified a series of medications and natural substances that could be developed for preventing suicide.

“Our work provides a basis for precision medicine and scientific wellness preventive approaches,” said Alexander B. Niculescu III, M.D., Ph.D., professor of psychiatry and medical neuroscience at IU School of Medicine.

The article, “Precision medicine for suicidality: from universality to subtypes and personalization,” appears in the online edition of the journal, Molecular Psychiatry.

The research builds on earlier studies from the Niculescu group.

“Suicide strikes people in all walks of life. We believe such tragedies can be averted. This landmark larger study breaks new ground, as well as reproduces in larger numbers of individuals some of our earlier findings,” said Dr. Niculescu.

There were multiple steps to the research, starting with serial blood tests taken from 66 people who had been diagnosed with psychiatric disorders, followed over time, and who had at least one instance in which they reported a significant change in their level of suicidal thinking from one testing visit to the next.

The candidate gene expression biomarkers that best tracked suicidality in each individual and across individuals were then prioritized using the Niculescu group’s Convergent Functional Genomics approach, based on all the prior evidence in the field.

Next, working with the Marion County (Indianapolis, Ind.) Coroner’s Office, the researchers tested the validity of the biomarkers using blood samples drawn from 45 people who had committed suicide.

The biomarkers were then tested in another larger, completely independent group of individuals to determine how well they could predict which of them would report intense suicidal thoughts or would be hospitalized for suicide attempts.

The biomarkers identified by the research are RNA molecules whose levels in the blood changed in concert with changes in the levels of suicidal thoughts experienced by the patients. Among the findings reported in the current paper were:

  • An algorithm that combines biomarkers with the apps that was 90 percent accurate in predicting high levels of suicidal thinking and 77 percent accurate in predicting future suicide-related hospitalizations in everybody, irrespective of gender and diagnosis.
  • A refined set of biomarkers that apply universally in predicting risk of suicide among both male and female patients with a variety of psychiatric illnesses, including new biomarkers never before linked to suicidal thoughts and behavior.
  • Four new subtypes of suicidality were identified (depressed, anxious, combined, and non-affective/psychotic), with different biomarkers being more effective in each subtype.
  • Biomarkers that were associated with specific diagnoses and genders, such as one, known as LHFP, that appears to be a very strong predictor for depressed men.
  • Two of the biomarkers, APOE and IL6, have broad evidence for involvement in suicidality and potential clinical utility as targets for drug therapies, as well as suggest a neurodegenerative and inflammatory component to the predisposition to suicide. APOE is responsible for proteins involved with managing cholesterol and fats, and some forms of the gene have been strongly implicated as risks for Alzheimer’s disease. IL6 expresses proteins involved in the body’s inflammation response.
  • Potential drug therapies and natural substances for preventing suicide, using the blood biomarker signatures and bioinformatics approaches. They included medications already in use to treat psychiatric illnesses and drugs approved for other uses, such as the diabetes medication metformin.

Source: University of Indiana/EurekAlert

 
Photo: This is Alexander B. Niculescu III. Credit: Indiana University School of Medicine.

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Theresa May – action, not talk please.
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To say that I have mixed emotions with regard to Theresa May’s very well publicised speech yesterday, is an understatement. On the one hand, mental health received a shout out on TV. Amazing! The stigma and problems surrounding it were formally recognised. I also like the prospect that every secondary school will receive mental health first aid training, to help teachers identify symptoms and students who may be developing issues. […]

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5 Things Anxious People Hate. How Long Do Panic Attacks Last
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5 Things Anxious People Hate…But Try To Be Cool About

There are loads of perks to having an anxious friend. Sure, we tend to overthink things. We worry about every possible thing that could go…

The post 5 Things Anxious People Hate…But Try To Be Cool About appeared first on wE'Re AlL mAd HeRe.

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Off-Label Use of Antidepressants May Provide Pain Relief
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A new study suggests some of the most effective medications for chronic pain are the same medications that are used for depression.

At doses lower than those needed to treat depression, antidepressants can relieve chronic pain in conditions ranging from diabetic neuropathy, migraine and tension headaches, to osteoarthritis and fibromyalgia.

Experts explain, however, that most medications have significant associated side-effects and the ability to tolerate these side effects varies between individuals.

Side effects may depend on other medications an individual is using, or could be influenced by other existing health issues. Therefore, predicting the ability to tolerate such side effects could be crucial for the success of an antidepressant in treating pain.

This scenario is discussed in a recent article by Dr. Carina Riediger and colleagues in Dr. Timo Siepmann’s group at the University Hospital Carl Gustav Carus, in Dresden, Germany. The paper appears in the online journal Frontiers in Neuroscience.

“Understanding adverse effects and their impact on patients’ quality of life is crucial in modern clinical medicine and poses a substantial challenge to clinicians who face a exponentially growing range of available medical therapies” said Siepmann, the principal investigator of this study.

To help physicians match a chronic pain sufferer to a suitable antidepressant, their group performed a systematic study and meta analysis of the reported adverse effects for a wide variety of commonly used antidepressant drugs, each with its own side effect profile.

These antidepressants fall into different categories based on their mechanism of action, such as tricyclic antidepressants amitriptyline (Elavil) and nortriptyline (Pamelor), and serotonin reuptake inhibitors venlafaxine (Effexor), duloxetine (Cymbalta) and milnacipram (Ixel), among others.

The study collected all reported adverse effects for these drugs in the clinical literature from the past two decades. These side effects ranged from dizziness, dry mouth, and drowsiness, to palpitations, weight gain, sexual and urinary dysfunction, and hypertension, to name a few. The researchers also took into account whether treatment was discontinued due to the severity of these side effects.

Researachers found that almost all antidepressants presented significant side effects, and no drug was clearly superior to others. However, clinical data also showed that some individuals might better tolerate certain side effects than others, and therefore, the authors recommend personalized medicine.

For instance, dizziness and drowsiness as side effects may not be acceptable for individuals who drive vehicles or operate heavy machinery. On the other hand, some sedation might be tolerated, and perhaps even be desirable, in a chronic pain patient with sleep disruptions or insomnia.

These results may help physicians improve treatment outcomes by better matching the health status of chronic pain patients to their antidepressant medication.

“Dr. Riediger’s work contributes to this understanding, but further research is needed to improve general treatment recommendations and enable personalized multimodal therapy which is tailored to the patient’s individual health situation and includes non-pharmacological strategies in addition to pharmacotherapy,” Siepmann said.

Source: Frontiers/EurekAlert

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Abdominal Pain: Why Youre Hurting In These 9 Areas Of Your Tummy
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Everyone gets a stomachache now and again. Maybe you’re hungry, or maybe you ate too much, or something didn’t agree with you. Other times, it might be a symptom of a stomach virus, or even a sign of stress and anxiety. Other times, it’s an indication that something might be up with one or more […]

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We’re All Mad Here – Giveaway!
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Greetings all! We made it through January, (by the skin of our teeth) and now it’s time to embrace February and all the possibilities that it may bring. But how? I hear you ask. Well what better way to celebrate the end of the most depressing month of the year than with…. BADGES!!  For the chance to win one please tweet this message: It’s Feb & We’re All Mad Here! https://www.amazon.co.uk/d/Books/Were-Here-Nonsense-Guide-Living-Social-Anxiety/1785920820 #Allmadherebook @ClaireyLove  […]

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video: what someone with mental illness looks like
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welcome to my first-ever video post! 🙂

i do lots of public speaking about mental illness in the washington d.c.-metro area but until now haven’t gotten any of my talks on tape. i am so excited to share this with you.

last weekend i had the opportunity to share my story at the church i grew up in (rock spring congregational united church of christ). until recently i did not talk openly about my diagnoses or struggle with mental illness  – including within this church.  so i focused my remarks on what someone with mental illness looks like  – or doesn’t look like – to raise awareness that it can impact anyone. even someone, like me, who looks like they are totally fine.

i think it is so important to push back at stigma by putting a human face on depression, anxiety and ptsd. and, more personally, sharing so openly and authentically helps me to take another step on my healing journey. best of all, conversations like this open the door for others to talk about their own challenges and ask for help. i am grateful all around to be a part of this life-changing work.

hope you enjoy!
xo,
amy

“since sharing my story publicly i have been told  many times that i don’t look like someone who has a mental illness…

if you want to know what someone with severe mental illness looks like, they look like me.

they look just like me.”

The post video: what someone with mental illness looks like appeared first on blue light blue.

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Maura Keaney on the Language of Suicide Loss
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This post is the fourth in a new series of guest conversations called Voices on Mental Health.  I am honored to showcase inspirational people with unique and important perspectives on mental illness.

Our fourth piece in this series features the perspective of Maura Keaney, a survivor of suicide loss who lives with depression. Maura has been part of my life for a long, long time. She was my middle school English teacher the year that my dad died by suicide.  She was the one I wanted by my side on that very first, most awful day, and she has been my  mentor and friend ever since. (She also taught me how to write so we can all thank her for my stellar grammar skills!) When I was in the midst of my severe episode a few years ago, I talked to Maura almost every day. Her sincere, uncritical acceptance was a lifeline for me. Maura helped me see that my fight with depression, anxiety and PTSD was heroic. That I had a legitimate, medical illness – not a personal flaw or failing. It’s hard to express what her support has meant to me over the years – and still means to me today.

Yesterday she posted the below statement on her Facebook page in response to the death of Chris Cornell, lead singer of Soundgarden, who died by suicide – and I want to share it with you. She captured my thoughts exactly. Every time we lose a celebrity to suicide I am so triggered – not by the death itself, but by the insensitive way that the media and the general public talk about it. We don’t ask people whose loved one died of cancer why we didn’t do more to save them.  Severe, suicidal depression is no different. As Maura says, “If love could cure it, then none of us who have lost someone to suicide would have lost our loved ones. Suicide doesn’t make Chris a bad person – it makes depression a really bad disease.”


Chris Cornell’s death from depression by suicide is heartbreaking, and some of the reactions to it are infuriating. I’m reading a lot of recrimination of him even among my own friends and their friends, implying that he is a horrible person because his family should have been reason enough to live, or that with all of his money, he should have been able to get himself lifesaving treatment.

The story here is that all the fame in the world, all of the talent, all of the success, all of the money, and the love of devoted family are not in themselves vaccines against lethal depression. Depression is not a deficiency of love, success, or money. It is a brain illness. Money in itself can’t cure it any more than Steve Jobs could cure his pancreatic cancer with half of the wealth of the Western Hemisphere at his disposal. If love could cure it, none of us who have loved ones who have died by suicide would have lost our loved ones. If love were a cure, I could have cured my mom’s depression when I was a preschooler, and I’d have plenty of medicine for my own.

I do not mean to imply that it is hopeless. Deaths by suicide are preventable. But there is no perfect medical cure for depression. There is no guaranteed path that makes everyone better or a magic pill that always works. We don’t know how hard he tried to save his own life. We don’t know what lies his brain was telling him yesterday. All we know is that he had every reason to live but that depression killed him anyway. Suicide doesn’t make him a bad person. It makes depression a really bad disease.

If you’re feeling suicidal thoughts, you are not a bad person. You are not selfish. You deserve to live. Many, many people want to help keep you alive.

I am one of them.

I’m here.

The post Maura Keaney on the Language of Suicide Loss appeared first on blue light blue.

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Anxiety, stressed oot ma nut! (Update) How long do panic attacks last
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Long time no blog! My final year of university has so far kept me extremely busy (and stressed out), and the Christmas holidays have been the last time I will get a break until May, so naturally, I haven’t been in much of a writing mood. I have really missed my blog though. I still have loads of things that I want to write about, but unfortunately – as I will have to start work on my honours in just a couple of days (eeeeeeeek!) – most of those future blog posts will have to be postponed by a few months.

Things aren’t great at the moment. I now have no close friends as my online friend has stopped talking to me. He was very depressed and made some nasty comments towards me despite me doing all I could to try and help/ support him, and stopped talking to me not long after that. I know that none of it was really my fault, but I can’t help but feel bad about myself for all of the times that friends have abandoned me throughout my life. It certainly doesn’t help my self-esteem or my mood. But if someone wants to treat me badly when I’m going out of my way to help them, they aren’t really my friend. I’m quite used to giving more than I get back in return from close friendships, but if someone wants to be ungrateful and rude towards me, I’ll try to find people who will treat me with the respect I deserve. I have no idea how to do this though. I always seem to make the mistake of only making one close friend, so it hurts a lot when they abandon me. This probably has a lot to do with my social anxiety, but when I look back on the friendships I’ve had throughout my life, I valued the friendship far more than the other person did in the vast majority of cases. I imagine that this is a common thing in people with severe SA. Most people without SA usually don’t have too much trouble making friends, and usually have multiple friendships, but those of us with severe SA may only have one close friend (if we are lucky). Therefore, each friendship is much more precious to us than to people who are not socially anxious.

I do still have three non-close friends, but I only see two of them every few months (and I’m not even sure that one of those people is really even my friend, given the way she treats me sometimes). I haven’t seen my other friend since July, and she won’t be back in Edinburgh until May, so I’ve been communicating with her exclusively through email.

I started talking to someone from an online dating site back in September. He seemed understanding when it came to my mental health issues (as he had to deal with the same things himself). We had a lot in common, seemed to be getting on really well, and both wanted to make a relationship work. Then a lot of really difficult things in his life happened in a very short space of time. I wanted to do whatever I could to support him, but he dealt with the difficult things he was going through by shutting me out/ not communicating with me at all for a fortnight. Given my issues around rejection, it was difficult for me to be completely ignored for 2 weeks by someone who claimed that they wanted to be in a relationship with me. He then stopped talking to me altogether. We didn’t even meet up with each other. I still feel bad about the way I left things with him, because there were so many difficult things that he was going through and (despite not taking kindly to being completely ignored/ shut out for two weeks) I really did just want to help and support him. Ultimately though, I think both of us were/ are too unstable and not in the right state of mind to have a healthy relationship. I’ve recently thought about trying online dating again, but I probably won’t have the time/ energy to dedicate to a relationship until university is over. Or maybe I’m just making excuses. Perhaps I’m wrong, but I don’t think it’s possible to have a healthy relationship if you don’t have any friends that you see on a somewhat regular basis/ are close to. What does everyone else think? The trouble with that view, however, is that I can’t be in a relationship until I make some close friends, and it seems that friends are usually a prerequisite for making new friends. Given this, and given my social ineptitude, it seems like a bit of a Catch-22 situation.

What scares me is that when I was talking to that guy from the online dating site, I was the happiest that I have been in a very long time. I can’t rely on another person for my happiness because it’ll destroy me when things end. Am I too reliant on other people? Or not enough? Why give another person the power to destroy me?

I mentioned a few posts ago that I’d hardly seen my befriender, despite the fact that we were supposed to meet up with each other about once every two weeks. I actually met up with her again earlier today. I hadn’t seen her since September, and before that, the last time I met up with her was back in May. To be fair to her, she has had a lot of very difficult/ stressful things going on in her life this past year, so I don’t blame her. When the woman in charge of befriending at the mental health charity found out that we’d been meeting so infrequently, she looked into getting me a second befriender who would be able to meet up with me more often. I’ve met up with my new befriender a couple of times, and she seems really nice. Ideally, my new befriender will be able to go along to meet up groups with me and support me with meeting/ attempting to befriend new people. I don’t really hold out much hope though. I find it so, so difficult to open up to people, and I don’t know how to tell her about my anxiety and lack of close friendships. I also struggle to make friends face-to-face, and would have to somehow overcome the negative “voice� in my head that tells me I won’t be able to make friends because I’m so socially inept and weird that no one would like me. There’s also the fact that I may not have the time to go along to many meet up groups, given the hellish onslaught of university coursework that awaits me. We’ll see how it goes. I’m feeling really hopeless and miserable about my lack of close friendships and of a relationship but I’m doing the best I can to distract myself from thinking about it too much. I can bury myself in university work soon. My old befriender and I have finally arranged to go to a meet up together later this week, and my new befriender and I may be meeting up again next week, so at least I do have a couple of (hopefully) positive things to look forward to.

Random picture of a capuchin monkey that I took, just to break up the wall of text a bit

Random picture of a capuchin monkey that I took, just to break up the wall of text a bit

Work is probably the thing that has helped me the most in recent times, despite the near-fainting, awful insomnia, and other ailments that my anxiety around work has caused me (SA is such a lovely condition!) The insomnia is probably the worst of these. In the week leading up to Christmas, work started at 4am. I averaged only about 3 hours of sleep per night for the whole week. This definitely didn’t help my mental health, and I was very stressed out and irritable. Strangely though, I seemed to function better socially for much of that week. Maybe I was so tired that I didn’t care as much about what other people thought of me, or perhaps it was just the long shifts and the fact that I was working every day that helped me. I still suffer from pre-work insomnia, even though we’re back to 6am starts now. Some nights I don’t get any sleep at all before work, which, again, definitely doesn’t help with my mental state. I really hate all the side-effects of anxiety, but I am so lucky to have gotten this job, and it has helped me so much, so I will keep on soldiering on through it all. I’ve learned that it’s better to just be with the anxiety rather than trying to control it. I usually find that the more I try to control my anxiety, the more it controls me.

It’s amazing how high-functioning I can be at times. I don’t know if any of my colleagues would guess that I’m a nervous wreck on the inside (though I’m sure they’ve realised that I’m very awkward and weird, and that my behaviour can be a bit odd at times). I think my social skills have improved slightly but people attempting to converse with me probably still find it very awkward and stilted. Some days are better than others. I’m definitely less anxious when it comes to talking to/ helping customers. As soon as a customer approached me, my initial thoughts used to be something along the lines of: “Oh shit. SHIT! They’re talking to me! What do I do? Why can’t the ground swallow me up?� Obviously, I still get anxious, but it’s somewhat more manageable now. I’m also a bit better at actually getting my words out/ responding to people, rather than my anxiety causing me to completely freeze up. It’s amazing to think that less than 4 years ago, my anxiety in supermarkets was so bad that I struggled to be in one on my own for any more than about 10 minutes. Now I can stay in one for 8 hours or more, with relative ease, even during the week leading up to Christmas. I could quite easily do a full supermarket shop now.

I feel that I have matured somewhat in some areas, even if I am still well behind most people my age in many areas. I still don’t have any friends at work (again, the main reason for this is probably my fear of opening up to people/ letting others get close to me). Despite knowing full well that no matter who you are, you are always going to have people who dislike you, and despite knowing that this may be more to do with the other person than a reflection on me, and that what other people think about me is none of my business, I still see being disliked in any way by another person as a failure on my part, even if they only dislike a part of me, such as my awkwardness, or how quiet I am at work. (Sorry, that one should’ve had a “long sentence warning� on it. Hope no one fell asleep half-way through it). Perhaps this is why I am so reluctant to open up to others.

Sleepy squirrel monkey

Sleepy squirrel monkey

Something that worries me is that lately, I’ve been having intrusive thoughts, which mostly centre on bad things happening to me or to family members. I mentioned earlier that my anxiety around work often prevents me from sleeping when I have work the next day. The intrusive thoughts always seem to be worse/ more frequent when I’m sleep-deprived, and my brain also seems able to make just about anything disturbing (re: intrusive thoughts) when I’m in a sleep-deprived state. In the past, I’ve had occasional intrusive thoughts during times of stress, but not quite as bad as this. I feel awful about having such thoughts, even though I know I shouldn’t. I’m hoping that this is just a temporary thing and not something that will become more of a permanent feature in my mental landscape. Thankfully, I’ve slept reasonably well for the last few nights and the intrusive thoughts have been less frequent. I am so, so grateful that OCD is not something I have to deal with, because even the relatively infrequent and mild intrusive thoughts that I’ve had to deal with recently are disturbing and upsetting to me.

Last term at university was horrendous but I’ll cover that in another post, seeing as how I’ve already typed up an essay for this post. One positive thing that happened not long after my last post on this blog is that I went along to a women’s cycling group. At the time, I was feeling quite hopeless, as I had gone along to a nature meet up group not long before that, and felt miserable/ like an outcast the whole time that I was there, and spent the entire meet up wishing that I could go home. I was really nervous about going along to the cycling group, especially as I seemed to be the youngest person there. Things didn’t seem to be going well at first, as everyone else already knew each other and I wasn’t able to join in on the conversation. I once again started to wish that I hadn’t bothered going along, but as soon as we actually started cycling, I began to enjoy it. At one point, we all stopped at a café, and I managed to talk to a few of the women in the group. I also managed to eat in front of them without too much trouble. Overall, I really enjoyed the experience. I haven’t been along to the group since (mostly due to being busy with university and work), but hope to go along to the group somewhat regularly once university is over.

Another (supposed) positive is that I FINALLY started Interpersonal Therapy last week. As I had been on the waiting list since June, the psychologist who referred me has sent me information on how to make a complaint against the NHS. I’m still undecided as to whether or not I will make a complaint. It seems like more trouble than it’s worth, and I doubt it will do anything whatsoever to change the deeply flawed and failing public mental health services. Has anyone reading this blog ever gotten any positive results from making a complaint about mental health services?

It’s always difficult for me to start seeing a new psychologist/ psychiatrist. I’ve grown to somewhat dislike/ distrust the profession due to my previous experiences of the mental health services. The psychologist I saw seemed nice enough, though she recorded the wrong scores for the PHQ-9 questionnaire that I filled out (always encouraging!) She said that unlike with CBT, I could have up to 20 sessions of IPT. I feel that I probably do need more long-term therapy if I’m going to make any significant progress, so that’s good to know. I want to eventually do group CBT once university is over as well. (Have you noticed the common factor in terms of what is currently impeding my recovery/ generally ruining my life at the moment?)

I am absolutely dreading my honours project. As is typical of the (complete lack of) organisation at my university, we have only two weeks to write the proposal for our dissertation, and many people don’t even know what topic they’re doing yet. The deadline for the proposal is on my birthday, so this should be fun. We had an introductory session earlier today and I am freaking out at how much work needs to be done between now and May. As I said earlier, it’s annoying, because I have so much I want to write about, but it’ll just have to wait. Anyway, I’ve nattered on for more than long enough. Thanks for reading if you’ve made it this far without falling asleep like that squirrel monkey.

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