Early childhood depression alters brain development

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"The brains of children who suffer clinical depression as preschoolers develop abnormally, compared with the brains of preschoolers unaffected by the disorder, according to new research at Washington University School of Medicine in St. Louis. Their gray matter -- tissue that connects brain cells and carries signals between those cells and is involved in seeing, hearing, memory, decision-making and emotion -- is lower in volume and thinner in the cortex, a part of the brain important in the processing of emotions. The new study is published Dec. 16 in JAMA Psychiatry. "What is noteworthy about these findings is that we are able to see how a life experience -- such as an episode of depression -- can change the brain's anatomy," said first author Joan L. Luby, MD, whose research established that children as young as 3 can experience depression. "Traditionally, we have thought about the brain as an organ that develops in a predetermined way, but our research is showing that actual experience -- including negative moods, exposure to poverty, and a lack of parental support and nurturing -- have a material impact on brain growth and development." The findings may help explain why children and others who are depressed have difficulty regulating their moods and emotions. The research builds on earlier work by Luby's group that detailed other differences in the brains of depressed children. Luby, the Samuel and Mae S. Ludwig Professor of Child Psychiatry, and her team studied 193 children, 90 of whom had been diagnosed with depression as preschoolers. They performed clinical evaluations on the children several times as they aged. The researchers also conducted MRI scans at three points in time as each child got older. The first scans were performed when the kids were ages 6 to 8, and the final scans were taken when they were ages 12 to 15. A total of 116 children in the study received all three brain scans. "If we had only scanned them at one age or stage, we wouldn't know whether these effects simply were present from birth or reflected an actual change in brain development," said co-investigator Deanna M. Barch, PhD, head of Washington University's Department of Psychological and Brain Sciences in Arts & Sciences. "By scanning them multiple times, we were able to see that the changes reflect an actual difference in brain maturation that emerges over the course of development." The gray matter is made up mainly of neurons, along with axons that extend from brain cells to carry signals. The gray matter processes information, and as children get older, they develop more of it. Beginning around puberty, the amount of gray matter begins to decline as communication between neurons gets more efficient and redundant processes are eliminated. "Gray matter development follows an inverted U-shaped curve," Luby said. "As children develop normally, they get more and more gray matter until puberty, but then a process called pruning begins, and unnecessary cells die off. But our study showed a much steeper drop-off, possibly due to pruning, in the kids who had been depressed than in healthy children." Further, the steepness of the drop-off in the volume and thickness of the brain tissue correlated with the severity of depression: The more depressed a child was, the more severe the loss in volume and thickness. The researchers determined that having depression was a key factor in gray matter development. In scans of children whose parents had suffered from depression -- meaning the kids would be at higher risk -- gray matter appeared normal unless the kids had suffered from depression, too. Interestingly, the differences in gray matter volume and thickness typically were more pronounced than differences in other parts of the brain linked to emotions. Luby explained that because gray matter is involved in emotion processing, it is possible some of the structures involved in emotion, such as the brain's amygdala, may function normally, but when the amygdala sends signals to the cortex -- where gray matter is thinner -- the cortex may be unable to regulate those signals properly. Luby and Barch are planning to conduct brain scans on even younger children to learn whether depression may cause pruning in the brain's gray matter to begin earlier than normal, changing the course of brain development as a child grows. "A next important step will involve determining whether early intervention might shift the trajectory of brain development for these kids so that they revert to more typical and healthy development," said Barch, also the Gregory B. Couch Professor of Psychiatry. Luby said that is the main challenge facing those who treat kids with depression. "The experience of early childhood depression is not only uncomfortable for the child during those early years," she said. "It also appears to have long-lasting effects on brain development and to make that child vulnerable to future problems. If we can intervene, however, the benefits might be just as long-lasting." ### Funding from the National Institute of Mental Health and the National Institutes of Health Blueprint of the National Institutes of Health (NIH), grant numbers R01 MH66031, R01 MH084840, R01 MH090786, R01 MH098454-S, U54 MH091657, 2R01 MH064769-06A1, PA-07-070 NIMH R01 5K01MH090515-04 and T32 MH100019. Luby JL, Belden AC, Jackson JL, Lessov-Schlaggar CN, Harms MP, Tillman R, Botteron K, Whalen D, Barch DM. Early childhood depression and alterations in the trajectory of gray matter maturation in middle childhood and early adolescence?. JAMA Psychiatry, published online Dec. 16, 2015. http://jamapsychiatry.com doi:10.1001/jamapsychiatry.2015.2356 Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare." For more information on depression and other mental health related topics,please visit Aspira Continuing Education Online Courses

Community-based Treatments Offset Depression Disparities

Depression can affect anyone, but it hits ethnic groups more heavily partly because of reduced access to quality mental health care. To offset this imbalance, researchers from the RAND Corporation and UCLA, and community partners from more than two dozen community agencies, compared whether evidence-based quality improvement programs, which include psychotherapies such as cognitive behavioral therapy and antidepressant medications, are better implemented through involvement of the entire community or through clinic-based programs. The researchers polled 1,018 depressed patients in 90 randomized community- and clinic-based programs. The community-based approaches--in such places as churches, senior centers, and barber shops--worked best at improving mental-health quality of life, increasing physical activity, reducing homelessness risk factors, and getting more people to seek hospital and primary physician care. Project officer and Associate Director of Dissemination and Implementation Research David Chambers, Ph.D., discusses in a video the significance of these findings. For further details, see RAND Corporation’s press release, “Incorporating Community Groups Into Depression Care Can Improve Coping Among Low-Income Patients, Study Finds.” Aspira Continuing Education Online Courses

Holiday Suicides: Fact or Myth?

The idea that suicides occur more frequently during the holiday season is a long perpetuated myth. The Annenberg Public Policy Center has been tracking media reports on suicide since 2000. A recent analysis found that 40% of articles written during the 2008 holiday season perpetuated the myth.1

CDC’s National Center for Health Statistics reports that the suicide rate is, in fact, the lowest in December.1 The rate peaks in the spring and the fall. This pattern has not changed in recent years. The holiday suicide myth supports misinformation about suicide that might ultimately hamper prevention efforts. MFT Continuing Education http://www.aspirace.com
Suicide remains a major public health problem, one that occurs throughout the year. It is the 11th leading cause of death for all Americans. Each year, more than 33,000 people take their own lives.2 In addition, more than 376,000 are treated in emergency departments for self-inflicted injuries.2

CDC works to prevent suicidal behavior before it initially occurs. Some of CDC’s activities include:

1.monitoring suicidal behavior;
2.conducting research to identify the factors that put people at risk or protect them from suicide; and
3.developing and evaluating prevention programs.

Genetic attribution for schizophrenia, depression, and skin cancer: impact on social distance.

Genetic attribution for schizophrenia, depression, and skin cancer: impact on social distance.
New Zealand Journal of Psychology| November 01, 2007 | Breheny, Mary | COPYRIGHT 1998New Zealand Psychological Society. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright
Genetic explanations for mental and physical illness are increasingly common in both scientific research and in media reports generated from such research, however, the social impact of these explanations are less well understood. In this study it was predicted that both genetic attribution for illness and type of illness would be related to a desire for social distance. Participants were provided with a description of Jamie, who suffered from skin cancer, major depression, or schizophrenia. This illness was described as either having a strongly genetic basis, no genetic basis, or no causal explanation was provided. Participants then indicated their willingness to interact with Jamie using the Social Distance Scale. Type of illness described did significantly influence social distance score, with participants more willing to interact with Jamie when he was described as having skin cancer than schizophrenia or major depression. There was a significant interaction between illness type and genetic attribution for illness, with an increase in willingness to interact when schizophrenia was described as genetically caused and a decrease in willingness to interact when major depression was described as genetically caused. Genetic explanations may be suggested to reduce the stigma associated with mental illnesses, however, these explanations work in complex ways and may not uniformly reduce illness related stigma.

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The role o f genetics in determining health and wellbeing is increasingly discussed in scientific research (de Jong, 2000) and in media reports of such research (Conrad, 2001). The genetic component of complex traits is often investigated (de Jong, 2000), including the contribution of genetics to criminality (see Lowenstein, 2003; Martens, 2002; Retz, Retz-Junginger, Supprian, Thome & Rosler, 2004), and mental illness (see Thompson, Watson, Steinhauer, Goldstein & Pogue-Geile, 2005). Media representations contribute to lay explanations, and genetic factors are commonly identified as causing mental illness. Around two thirds of an Australian community sample attributed schizophrenia and depression to genetic causes (Jorm, Christensen & Griffiths, 2005). However, the impact of a claim of a genetic basis for complex psychological traits has received relatively little attention (Lemke, 2004), and may be a useful framework for understanding public attitudes towards those with mental illnesses (Zissi, 2006).

Genetic Attribution

Genetic explanations may influence understandings of human behaviour and the stigma associated with these behaviours (Phelan, 2005). Reframing mental illness as a brain disease with a genetic component has been suggested to reduce the stigma associated with mental illness; however, conversely, this may exacerbate experience of stigma (Bag, Yilmaz, Kirpinar, 2006; Corrigan & Watson, 2004). In support of this, Dietrich, Matschinger and Angermeyer (2006) found that biological or genetic causes of schizophrenia were associated with greater fear and reduced willingness to interact with people with schizophrenia. Phelan (2005) also found that genetic causes were associated with greater seriousness, persistence, and transmissibility of deviance. Research has found less blame attributed to those with genetically caused schizophrenia (Phelan, 2002), and less stigma associated with causes beyond the patients control, including genetic transmission (Martin, Pescosolido & Tuch, 2000; van't Veer, Kraan, Drosseart, & Modde, 2006). Phelan (2005) found some participants reported both reduced blame and increased associative stigma for genetically caused mental illnesses. Genetic causes for mental illness may have complex effects, ameliorating the blame associated with mental illness, bur increasing stigma.

Social Distance

Stigma is an attribute that discredits an individual, reducing them from a whole person to a discounted person in the eyes of others (Major & O'Brien, 2005). The evaluations of stigmatised others are widely shared, and are used as the basis for excluding or avoiding members of the discredited category (Major & O'Brien, 2005). Social distance is a way to assess attitudes towards those with a stigmatised identity, and is defined as the relative willingness to participate in relationships of varying intimacy with those who have a devalued social identity (Lauber, Nordt, Falcato & Rossler, 2004). Measures of social distance are widely used to assess attitudes to mental illness (Reinke, Corrigan, Leonhard, Lundin & Kubiak, 2004), by measuring participants' reported willingness to engage in relationships with a person described as having a particular illness (Lauber et al., 2004).

National Strategy for Suicide Prevention

National Strategy for Suicide Prevention: Goals and Objectives for Action CEU Course


1. Increase awareness of suicide prevention methods
2. Increase familiarity with broad based support systems
3. Become familiar with strategies to reduce stigma
4. Learn how to promote efforts to reduce efforts to lethal means of self harm.
5. Identify at risk behavior
6. Implement appropriate treatment and resources
7. Develop and Promote Effective Clinical and Professional Practices
Table of Contents:
1. GOAL 1: Promote Awareness that Suicide is a Public Health Problem that is Preventable
2. GOAL 2: Develop Broad-Based Support for Suicide Prevention
3. GOAL 3: Develop and Implement Strategies to Reduce the Stigma Associated with Being a Consumer of Mental Health, Substance Abuse, and Suicide Prevention Services
4. GOAL 4: Develop and Implement Community-Based Suicide Prevention Programs
5. GOAL 5: Promote Efforts to Reduce Access to Lethal Means and Methods to Self-Harm
6. GOAL 6: Implement Training for Recognition of At-Risk Behavior and Delivery of Effective Treatment
7. GOAL 7: Develop and Promote Effective Clinical and Professional Practices
8. GOAL 8: Improve Access to and Community Linkages with Mental Health and Substance Abuse Services
9. GOAL 9: Improve Reporting and Portrayals of Suicidal Behavior, Mental Illness, and Substance Abuse in the Entertainment and News Media
10. GOAL 10: Promote and Support Research on Suicide and Suicide Prevention
11. GOAL 11: Improve and Expand Surveillance Systems
12. Looking Ahead
13. References
GOAL 1: Promote Awareness that Suicide is a Public Health Problem that is Preventable
Why is this Goal Important to the National Strategy?
In a democratic society, the stronger and broader the support for a public health initiative, the greater its chance for success. The social and political will can be mobilized when it is believed that suicide is preventable. If the general public understands that suicide and suicidal behaviors can be prevented, and people are made aware of the roles individuals and groups can play in prevention, many lives can be saved.
In order to mobilize social and political will, it is important to first dispel the myths that surround suicide. Many of these myths relate to the causes of suicide, the reasons for suicide, the types of individuals who contemplate suicide, and the consequences associated with suicidal ideation and attempts. Better awareness that suicide is a serious public health problem results in knowledge change, which then influences beliefs and behaviors (Satcher, 1999). Increased awareness coupled with the dispelling of myths about suicide and suicide prevention will result in a decrease in the stigma associated with suicide and life-threatening behaviors. An informed public awareness coupled with a social strategy and focused public will lead to a change in the public policy about the importance of investing in suicide prevention efforts at the local, State, regional, and national level (Mrazek & Haggerty, 1994).
Background Information and Current Status
The factors that contribute to the development, maintenance, and exacerbation of suicidal behaviors are now better understood from a public health perspective (Silverman & Maris, 1995). A public health approach allows suicide to be seen as a preventable problem, because it offers a way of understanding pathways to self-injury that lend themselves to the development of testable preventive interventions (Gordon, 1983; Potter, Powell & Kachur, 1995). Although some have criticized the public health model of suicide as being too disease-oriented, it does, in fact, take into account psychological, emotional, cognitive, and social factors that have been shown to contribute to suicidal behaviors (Potter, Rosenberg, & Hammond, 1998).
Did You Know?
In the 10 years 1989-1998, 307,973 people died as a result of suicide.
Suicide is a major public health problem. It is one of the top ten leading causes of death in the United States, ranking 8th or 9th for the last few decades. For the approximately 31,000 suicide deaths per year, there are an estimated 200,000 additional individuals who will be affected by the loss of a loved one or acquaintance by suicide. The economic and emotional toll on the Nation is profound (Palmer, Revicki, Halpern, & Hatziandreu, 1995).
How Will the Objective Facilitate Achievement of the Goal?
The objectives established for this goal are focused on increasing the degree of cooperation and collaboration between and among public and private entities that have made a commitment to public awareness of suicide and suicide prevention. To accomplish this goal, support for innovative techniques and approaches is needed to get the message out, as well as support for the organizations and institutions involved.
Objective 1.1:
By 2005, increase the number of States in which public information campaigns designed to increase public knowledge of suicide prevention reach at least 50 percent of the State's population.
Suicide has been designated as a serious public health problem by the U.S. Surgeon General, and the 105th U.S. Congress has recognized that this problem deserves increased attention [U.S. Senate Resolution 84 (5/6/97) and U.S. House Resolution 212 (10/9/98)]. They recognize suicide as a national problem and declare suicide prevention as a national priority, encouraging the development of an effective national strategy for the prevention of suicide. Public and private organizations have developed information campaigns to educate the public that suicide is preventable, as it can be a consequence of other treatable disorders such as depression, schizophrenia, bipolar illness, alcohol and drug abuse, and certain medical conditions. Campaigns alert professional, community, and lay groups about the common signs and symptoms associated with suicidal behavior. Some organizations with existing campaigns include the American Association of Suicidology (AAS), the American Foundation for Suicide Prevention (AFSP), the Suicide Awareness\Voices of Education (SA\VE), the Suicide Prevention Advocacy Network (SPAN USA), and Yellow Ribbon Suicide Prevention Program.
Ideas for Action Work with local media to develop and disseminate public service announcements describing a safe and effective message about suicide and its prevention.
Public information campaigns can take many forms. No single slogan or message works for everyone. For example, the primary purpose of the annual National Depression Screening Day is to identify, in a variety of settings, individuals with symptoms of depression and refer them for treatment (Jacobs, 1999b). However, such a screening program performed at primary care centers, mental health and substance abuse treatment centers, colleges, universities, and places of employment can play an important role in raising awareness and educating large groups of individuals about this mental disorder and its association with suicidal behaviors. Because no one
is immune to suicide the challenge is to develop a variety of messages targeting the young and the old, various racial and ethnic populations, individuals of various faiths, those of different sexual orientations, and people from diverse socioeconomic groups and geographical regions.
Objective 1.2:
By 2005, establish regular national congresses on suicide prevention designed to foster collaboration with stakeholders on prevention strategies across disciplines and with the public.
Broad-based participation and involvement is needed to ensure progress in reducing the toll of suicide. Open discussion and assessment of suicide prevention programs can only lead to their refinement and better chances for success.
The techniques and tools to create and implement prevention initiatives can be taught and demonstrated. Learning how to develop and disseminate public health messages and to mount public health campaigns is critical to implementing suicide prevention efforts.
A number of organizations have convened annual, national meetings devoted to suicide prevention. Currently, such meetings are sponsored by AAS, AFSP, and biennially by the International Association for Suicide Prevention (IASP). The establishment of regular national congresses on suicide prevention, collaboratively sponsored by more than one organization, will maintain interest and focus on this issue. Ideally, these national congresses should be sponsored by public/private partnerships (see Objective 2.2), and focus on needs and plans for coordinating effective suicide prevention efforts.
Ideas for Action Identify foundations and other stakeholders to contribute to the support of national congresses on suicide prevention.
Objective 1.3:
By 2005, convene national forums to focus on issues likely to strongly influence the effectiveness of suicide prevention messages.
National forums increase awareness of the problem of suicide and serve to mobilize social will. Such meetings keep the subject in the forefront of attention and raise concerns to the national level. Such activities increase connectedness between and among key stakeholders, and serve to bring support, consensus and collaboration to suicide prevention efforts.
Focusing on factors that influence the effectiveness of suicide prevention initiatives is critical to an overall strategy. National forums are opportunities to focus on specific issues that affect all efforts to mount suicide prevention initiatives. By highlighting specific areas, consensus can be reached on how best to incorporate elements into a suicide prevention plan and how best to evaluate effectiveness.
Ideas for Action Incorporate suicide awareness and prevention messages into employee assistance program activities in businesses with greater than 500
employees.
Objective 1.4:
By 2005, increase the number of both public and private institutions active in suicide prevention that are involved in collaborative, complementary dissemination of information on the World Wide Web.
The World Wide Web offers an unparalleled opportunity to bring public health information to a much broader audience because it can be accessed at home, at work, at schools, at community centers, at libraries, or at any other location where there is access to the Internet. Not only does the World Wide Web offer exciting possibilities for the delivery of public health messages (including promoting awareness and referral sources for those in need), but it offers an opportunity to develop preventive interventions as well.
For example, the World Wide Web offers the potential for interactive dialogue and exchange of accurate information. Clear, concise, and culturally sensitive public health messages are key to assisting individuals to evaluate their at-risk status accurately and to know where and how to get help. It therefore is important that both public and private institutions committed to suicide prevention activities collaborate and cooperate to deliver information that is consistent, comparable, complementary, and not competitive. In addition to several Federal websites (see Appendix D); some of the key national organizations currently disseminating suicide prevention information on the World Wide Web include AAS, AFSP, IASP, SPAN USA, and the American Academy of Pediatrics.
Did You Know? Suicide is the eighth leading cause of death for all Americans.
GOAL 2: Develop Broad-Based Support for Suicide Prevention

Family Psychoeducation

Family Psychoeducation
Workbook
Chapter 12: Readings and Other Resources
Essential Readings For Practitioners

The following four books are recommended references for those wanting to master this approach. The first includes key elements of the Anderson and Falloon approach and should be read first. The Miklowitz, et al., book is an important reference for those working with consumers with bipolar disorder.

McFarlane, W.R., Multifamily Groups in the Treatment of Severe Psychiatric Disorders, New York, NY, Guilford, 2002.

Anderson, C., Hogarty, G., Reiss, D., Schizophrenia and the Family, New York, NY, Guilford Press, 1986

Falloon, I., Boyd, J., McGill, C., Family Care of Schizophrenia, New York, NY, Guilford Press, 1984.

Miklowitz, D.J., Goldstein, M., Bipolar Disorder: A Family-focused Treatment Approach, New York, NY, Guilford Press, 1997

Additional Resources For Practitioners

Amenson, C., Schizophrenia: A Family Education Curriculum, Pacific Clinics, 1998.
Provides 150 slides with lecture notes for a class for families with a member with schizophrenia. Includes information about the illness, medication and psychosocial treatments and the role of the family in promoting recovery.


Amenson, C., Schizophrenia: Family Education Methods, Pacific Clinics, 1998.
Companion handbook to Schizophrenia: A Family Education Curriculum provides methods for forming a class, optimizing the learning of families, and dealing with typical problems that arise in conducting family classes.


Mueser K, Glynn S: Behavioral Family Therapy for Psychiatric Disorders. Oakland, New Harbinger Publications, 1999
A comprehensive model of single-Family Psychoeducation that includes a multifamily discussion/support group. The book contains individual educational handouts for various psychiatric diagnoses and handout for various related topic areas.
Psychopharmacology

The Essential Guide to Psychiatric Drugs by J. Gorman, St. Martin’s Press, 1995.
Written for a sophisticated consumer, it is the most accessible source of information about psychotropic medications. It distills the Physician’s Desk Reference into understandable language. It describes the individual “trees” (such as Prozac) in the forest of medicines. “The benzodiazepines: Are they really dangerous?” is a typical section heading.


Medicine and Mental Illness by M. Lickey and B. Gordon, Freeman, 1991.
A scholarly yet readable work written for professionals, it is best at teaching the principles of diagnosis, neurophysiology and psychopharmacological treatment of mental illness. It describes the “forest” of psychopharmacology, why it is there and how it works. “The blockade of dopamine receptors and antipsychotic potency” is a typical section heading. It does not discuss the profiles of individual medications.
Cultural Competence

The Cross-Cultural Practice of Clinical Case Management in Mental Health edited by Peter Manoleas, Haworth Press, 1996.
A collection of useful articles about the role of gender, ethnicity, and acculturation in treatment seeking and response. Provides guidelines for engaging and intervening with specific ethnic and diagnostic groups in varying treatment contexts.
Videotapes

Schizophrenia Explained by William R. McFarlane, M.D. Produced by, and order from, the author at Maine Medical Center, 22 Bramhall Street, Portland, ME 04102. (Phone 207-871-2091). mcfarw@mmc.org
This provides a full review in lay language of the psychobiology of schizophrenia, emphasizing the key concepts in Family Psychoeducation: stress reduction, optimal environments and interactions for recovery, and support for the family’s ability to contribute to recovery in many ways. It is often used in lieu of a psychiatrist during Family Education Workshops and for staffs of case management programs, community residences and employment programs to help them understand how to assist consumers with this disorder.


Exploring Schizophrenia by Christopher S. Amenson, Ph.D. Produced by the California Alliance for the Mentally Ill (Phone 916-567-0163).
This videotape uses everyday language to describe schizophrenia and give guidelines for coping with illness for consumers and their families.


Surviving and Thriving with a Mentally Ill Relative by Christopher Amenson, Ph.D., Third edition 1998.
Eighteen hours of good “home video quality” videotapes cover schizophrenia, bipolar disorder, major depressive disorder, medication, psychosocial rehabilitation, relapse prevention, motivation, and family skills. Order from Paul Burk, 1352 Hidden Springs Lane, Glendora, CA 91740. (Phone 626-335-1307).


Critical Connections: A Schizophrenia Awareness Video produced by the American Psychiatric Association, 1997.
This 30 minute video was designed by the APA to help consumers and families cope with the disabling effects of schizophrenia. It provides a hopeful, reassuring message about new medications and psychosocial treatments that assist with recovery.


Exploring Bipolar Disorder by Jerome V. Vaccaro, M.D., 1996
One hour professional quality videotape describes the illness, recovery, and the role of the family. Persons with the illness contribute valuable insights. Produced by and ordered from the California Alliance for the Mentally Ill, 1111 Howe Avenue, Suite 475, Sacramento, CA 95825. Phone 916-567-0163.
Periodicals

Schizophrenia Bulletin
Highly technical and difficult to read but it is the ultimate source for research findings. The fall 1995 issue summarizes “Treatment Outcomes Research”.


Psychiatric Services
Practical articles in all aspects of mental illness. Brief clinically relevant articles on medication and other treatments. The most useful periodical for clinical staff.


Psychosocial Rehabilitation
Practical psychosocial rehabilitation articles. Easy to read and understand. Provides “how to” details. Contains good consumer written articles.
Other Resources

There are a number of excellent books written for persons with a mental illness and their families to help them understand and deal with these illnesses. Many of these are helpful for professionals directly and all are important resources to which to refer patients and families. (See Reading List for Families.) Many of the professional and family books are offered at a discount by The National Alliance on Mental Illness, 200 N. Glebe Road, Suite 1015, Arlington, VA 22203-3754. Phone 703-524-7600.

Books on Mood Disorders (Bipolar and Unipolar Depressions)

A Brilliant Madness: Living with Manic Depressive Illness by Patty Duke and Gloria Hochman. (Bantam, 1992)
Combines personal experience with clinical information to describe manic depression in understandable terms and provide guidelines for coping with it.


Control Your Depression by Peter Lewinsohn, Ricardo Munoz, Mary Ann Youngren, and Antonette Zeiss.(Prentice Hall, Englewood Cliffs, New Jersey, 1979)
Self-help book which assesses contributors to depression and includes activities, relaxation techniques, thinking, social skills, self-control, and specific ideas and exercises for each problem area.


The Depression Workbook by Mary Ellen Copeland. (Harbinger, 1992)
Assists individuals in taking responsibility for wellness by using charts and techniques to track and control moods. The most complete and useful self help book for bipolar and unipolar depressions.


The Feeling Good Handbook by David Burns, (Penguin, New York, NY, 1989)
Self-help book presents rationale for cognitive therapy for depression. Gives specific ideas and exercises to help change thought patterns associated with depression and other problems.


Lithium and Manic Depression: A Guide by John Bohn and James Jefferson.
A very helpful guide for people with manic depression and their families regarding lithium treatment. Order from Lithium Information Center, Department of Psychiatry, University of Wisconsin, 600 Highland Ave., Madison, WI 53792.


Our Special Mom and Our Special Dad by Tootsie Sobkiewicz (Pittsburgh: Children of Mentally Ill Parents, 1994 and 1996)
Two interactive storybooks that allow primary school age children to understand and identify with the problems associated with having a mentally ill parent. Can be well utilized by a relative or therapist in individual or group work.


Overcoming Depression, Third Edition by D. & J. Papolos (Harper & Row, 1997).
A comprehensive book written for persons suffering from manic depression and major depression, as well as their families. It is the best source of information about these disorders. Does not offer coping strategies. This book and The Depression Workbook are the best two to read.


An Unquiet Mind by Kay Redfield Jamison
A compelling and emotional account of the author’s awareness, denial, and acceptance of her bipolar disorder. It offers hope and insight regarding recovery for anyone who reads it.
Books on Dual Diagnosis (Mental Illness and Substance Abuse)

Alcohol, Street Drugs, and Emotional Problems: What you need to know by B. Pepper and H. Ryglewicz.
These informative pamphlets come in versions for the client, for the family and for professionals. They can be ordered from TIE Lines, 20 Squadron Blvd. Suite 400, New York, NY 10956.


Lives at Risk: Understanding and Treating Young People with Dual Disorders by B. Pepper and H. Rygelwicz
Poignant description of the combination of schizophrenia, mood disorders, and/or personality disorders with substance abuse. Strong on empathy and understanding of the multiple problems. Provides little specific guidance.


Hazelden Publications (RW9 P.O. Box 176, Center City, MN 55012-0176 Phone 1-800-328-9000 or Website www.htbookplace.org
Publishes a large number of pamphlets and self-help books on substance abuse and dual diagnoses. Examples of titles include:
Preventing Relapse Workbook
Taking Care of Yourself: When a family member has a dual diagnosis
Twelve Steps and Dual Disorders
Understanding Schizophrenia and Addiction
Books About Children Who Have a Mental Illness

Children and Adolescents with Mental Illness: A Parents Guide by E. McElroy (Woodbine House, 1988)
Useful guide written by a psychologist who heads the NAMI Children’s and Adolescent network.


Educational Rights of Children with Disorders: A Primer for Advocates by Center for Law and Education. (Cambridge 1991.)


Neurobiological Disorders in Children and Adolescents by E. Peschel, R. Peschel and C. Howe. (Oxford Press, 1992)
Biological mental illnesses among children are less common and less understood “family problems”. This book helps to define childhood neurobiological disorders and gives guidance for finding appropriate treatment.
Books on Special Topics

Planning for the Future and the Life Planning Workbook by L. Mark Russell and Arnold Grant (American Publishing Company, 1995)
This book and accompanying workbook are guides for parents seeking to provide for the future security and happiness of an adult child with a disability following the parents’ deaths.


A Parent’s Guide to Wills and Trusts by Don Silver. (Adams-Hall, 1992)
Information on how to protect a disabled child’s financial future, written by an attorney and NAMI member.


Schizophrenia and Genetic Risks by Irving Gottesman.
This pamphlet contains detailed information about this single topic. It may be ordered from NAMI.


A Street is Not a Home: Solving American’s Homeless Dilemma by Robert Coates. (Prometheus, 1990)
Analysis and guide to dealing with homelessness among persons suffering from mental illness.


Suicide Survivors: A Guide for Those Left Behind by Adina Wrobleski. (Afterwards, 1991.)
With an understanding attitude, the author explores and offers coping suggestions for the many issues that confront families who have had a member kill himself.


Reading List For Families With A Member Who Has A Mental Illness
(Annotations by Christopher S. Amenson, Ph.D.)

Books Which Offer Guidance To Families

Coping with Schizophrenia: A Guide for Families by Kim Mueser and Susan Gingerich. (New Harbinger, 1994)
Comprehensive guide to living with schizophrenia and the best source for practical advice on topics including medication, preventing relapse, communication, family rules, drug use, and planning for the future. Includes forms and worksheets for solving typical problems.


Schizophrenia: Straight Talk for Families and Friends by Maryellen Walsh. (Morrow & Co., 1985).
A parent who, as a professional writer, thoroughly researched the field writes this book. This book is emotional in ways that will touch you and deals with all the issues important to families of persons of schizophrenia. If you can read only one book, select this one if you want to feel understood; select Understanding Schizophrenia to access current research on causes and treatments; select Coping with Schizophrenia if you want concrete advice about coping with the illness.


Surviving Schizophrenia: A Family Manual, Third Edition by E. Fuller Torrey. (Harper & Row, 1995).
Beloved by the Alliance for the Mentally Ill because it was the first book in 1983 to support and educate families. Contains one of the best descriptions of “The Inner World of Madness”. Discusses the major topics in easy to read and very pro-family language.


Troubled Journey: Coming to Terms with the Mental Illness of a Sibling or Parent by Diane Marsh and Rex Dickens (Tarcher/Putnam, 1997)
The best book for siblings and adult children. Helps to recognize and resolve the impact of mental illness on childhood. Seeks to renew self-esteem and improve current family and other relationships.


Understanding Schizophrenia: A Guide to the New Research on Causes and Treatment by Richard Keefe and Philip Harvey. (The Free Press, 1994)
The best description of research on schizophrenia as of 1994. It provides more depth and detail than Surviving Schizophrenia and is a little more difficult to read. A must for families that want to understand the science of schizophrenia.


How to Live with a Mentally Ill Person: A Handbook of Day-to-Day Strategies by Christine Adamec. (John Wiley and Sons, 1996)
This comprehensive, easy-to-read book is written by a parent. It reviews methods for accepting the illness, dealing with life issues, developing coping strategies, negotiating the mental health system, and more.
Books Describing The Experience of Schizophrenia

Anguished Voices: Siblings and Adult Children of Persons with Psychiatric Disabilities by Rex Dickens and Diane Marsh (Center for Psychiatric Rehabilitation, 1994.)
Collection of 8 well-written articles which describe the impact of mental illness on siblings and children. A poignant statement of the issues across the life span that need to be addressed when a person grows up with mental illness in the family.


Crazy Quilt by Jocelyn Riley (William Morrow, 1984)
Fictional account of a 13-year-old girl whose mother has schizophrenia. Written for children and adolescents. Provides understanding for these forgotten victims.


Is There No Place on Earth for Me? by Susan Sheehan. (Houghton-Mifflin, 1982.)
A very realistic depiction of the experience of schizophrenic woman is interwoven with information about legal, funding, and treatment issues. Gives a good description of historical and political influences on the treatment of persons suffering from schizophrenia. Won the Pulitzer Prize.


Tell Me I’m Here: One Family’s Experience with Schizophrenia by Ann Devesch. (Penquin, 1992)
Written by a United Nations Media Peace Prize winner and founder of Schizophrenia Australia, this book describes their family’s experience.


The Quiet Room by Lori Schiller. (1994)
The life story of a person who had an almost full recovery from schizophrenia with clozapine. Great for its inspirational value.


The Skipping Stone: Ripple Effects of Mental Illness on the Family by Mona Wasow (Science and Behavior Books, 1995)
Describes the impact of mental illness on each member of the family in a “Tower of Babel”. Information is from in-depth interviews with family members and professionals.


The Girl with the Crazy Brother by Betty Hyland (Franklin Watts, 1986)
Written for adolescents by an Alliance for the Mentally Ill member. Describes in short novel form the experience of a teenage girl trying to understand the sudden deterioration of her older brother.
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